Menjivar, Jorge Roberto

Menjivar, Jorge Roberto is an individual health care provider with primary practice located at 105 Honey Ln , Mcdonough GA 30252-6633. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Menjivar, Jorge Roberto can be contacted via phone (803) 873-8626.

Contact Information

Primary practice address
105 Honey Ln Mcdonough GA 30252-6633
Phone: (803) 873-8626
Fax: (803) 878-8099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN204394 Georgia

Profile Details

NPI number 1740721521
LBN Legal business name Menjivar, Jorge Roberto
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2017
Last updated Jul 29th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740721521 NPPES
Washington Other AP61443567 LICENSE
Washington Other 865069 LICENSE
Washington Other 95026632 LICENSE
Washington Other 10006776 LICENSE
Washington Other RN204394 LICENSE

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