Provider Demographics
NPI:1245496439
Name:JORGE N. PRIETO,M.D., P.A.
Entity type:Organization
Organization Name:JORGE N. PRIETO,M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:N
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-299-1040
Mailing Address - Street 1:1150 N 75TH PL
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-3302
Mailing Address - Country:US
Mailing Address - Phone:913-299-1040
Mailing Address - Fax:913-299-6622
Practice Address - Street 1:1150 N 75TH PL
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-3302
Practice Address - Country:US
Practice Address - Phone:913-299-1040
Practice Address - Fax:913-299-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0416843208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty