Provider Demographics
NPI:1982843074
Name:GARCIA, JOSE RAMON SR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAMON
Last Name:GARCIA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:1313 N CHEYENNE STREET
Mailing Address - City:BENKELMAN
Mailing Address - State:NE
Mailing Address - Zip Code:69021
Mailing Address - Country:US
Mailing Address - Phone:308-423-2204
Mailing Address - Fax:
Practice Address - Street 1:1313 N CHEYENNE STREET
Practice Address - Street 2:BOX 626
Practice Address - City:BENKELMAN
Practice Address - State:NE
Practice Address - Zip Code:69021
Practice Address - Country:US
Practice Address - Phone:308-423-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine