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Contact Information

KATHLEEN MEZOFF, MD
2111 COLLEGE DR
GALLUP, NM87301-5600
 Phone: 505-863-1820
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental - Behavioral Pediatrics

2080P0006X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KATHLEEN MEZOFF · (Female)

NPI Number 1942272208
Status Active
Credentials MD
Entity Individual
Enumeration date 02/02/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 80-68
  • AZ Medicaid 239922
  • NM Medicaid 13656
  • Other 85031326887301A131 CHAMPUS
  • NM Other NM001861 BCBS
  • NM Other 10002105 LOVELACE HEALTH/SALUD
  • NM Other PROVP14495 MOLINA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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