| Mr Douglas A North, PA-C | |
|
15136 St. Rd. 75, Penasco, NM 87553-0238 | |
| (575) 587-2205 | |
| (575) 587-1944 |
| Full Name | Mr Douglas A North |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 15136 St. Rd. 75, Penasco, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720071186 | NPI | - | NPPES |
| 81958757 | Medicaid | NM | |
| NM400307 | Other | NM | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 2001-PA27 (New Mexico) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Douglas A North, PA-C Po Box 158, 538 N. Paseo De Onate, Espanola, NM 87532-0158 Ph: (505) 753-7218 | Mr Douglas A North, PA-C 15136 St. Rd. 75, Penasco, NM 87553-0238 Ph: (575) 587-2205 |
David N Gould, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 15136 St. Rd. 75, El Centro Family Health Penasco Medical Clinic, Penasco, NM 87553 Phone: 575-587-2205 Fax: 575-587-1944 |