| B J Davis Dopc | |
|
3804 Montgomery Ne Albuqurque NM 87109 | |
| (505) 883-8099 | |
| (505) 883-8060 |
| Full Name | B J Davis Dopc |
|---|---|
| Speciality | Family Medicine |
| Location | 3804 Montgomery Ne, Albuqurque, New Mexico |
| Authorized Official Name and Position | B J Davis (OWNER) |
| Authorized Official Contact | 5058838099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| B J Davis Dopc 3804 Montgomery Ne Albuqurque NM 87109 Ph: (505) 883-8099 | B J Davis Dopc 3804 Montgomery Ne Albuqurque NM 87109 Ph: (505) 883-8099 |
| NPI Number | 1760555916 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 02/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760555916 | NPI | - | NPPES |
| 41723 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A40958 (New Mexico) | Primary |