Provider Demographics
NPI:1730529108
Name:ESCOBAR VALLE, JORGE LUIS (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:LUIS
Last Name:ESCOBAR VALLE
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:PO BOX 848
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0848
Mailing Address - Country:US
Mailing Address - Phone:610-208-8818
Mailing Address - Fax:
Practice Address - Street 1:875 POPLAR CHURCH RD STE 400
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2203
Practice Address - Country:US
Practice Address - Phone:610-208-8818
Practice Address - Fax:717-214-1068
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA256356207R00000X
MEMD22671207RC0000X
PAMD487089207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine