Basic Information
Provider Information
NPI: 1710143847
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIOS-PEREZ
FirstName: JORGE
MiddleName: ARTURO
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 117287
Address2:  
City: ATLANTA
State: GA
PostalCode: 303687287
CountryCode: US
TelephoneNumber: 8559632100
FaxNumber: 8133211296
Practice Location
Address1: 3100 PLAZA PROPERTIES BLVD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432191530
CountryCode: US
TelephoneNumber: 6143836000
FaxNumber: 6143836001
Other Information
ProviderEnumerationDate: 07/29/2008
LastUpdateDate: 07/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202X35-129181OHN Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
207RH0003X35-129181OHY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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