Provider Demographics
NPI:1942200282
Name:AROCHA, JOSE S (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:S
Last Name:AROCHA
Suffix:
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 1:248 DOCTORS ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NC
Mailing Address - Zip Code:28675-9421
Mailing Address - Country:US
Mailing Address - Phone:336-372-2481
Mailing Address - Fax:336-372-4153
Practice Address - Street 1:248 DOCTORS ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-9421
Practice Address - Country:US
Practice Address - Phone:336-372-2481
Practice Address - Fax:336-372-4153
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-02061207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2075272Medicare PIN
G35374Medicare UPIN