JEROME W BACA, PA-C, Medical ALBUQUERQUE, NM

Contact Information

JEROME W BACA, PA-C

6701 JEFFERSON ST NE
ALBUQUERQUE, NM 87109

Phone: 505-727-6200
Fax: 505-727-9590
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Medical	363AM0700X	97	Physician Assistant

Indicates primary specialty

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NPI Profile & details for JEROME W BACA · (Male)

NPI Number	`1811243462`
Status	Active
Credentials	PA-C (Physician Assistant-Certified)
Entity	Individual
Enumeration date	08/01/2012
Last updated	11/07/2019 - About 7 years ago
Sole proprietor ¹	No
Identifiers	NM License # PA2012-0025 NM Medicaid 64471870 NM Other PA2012-0025 NM MEDICAL LICENSE
Hospital affiliation(s)	LOVELACE MEDICAL CENTER - (Acute Care) 601 DR MARTIN LUTHER KING JR AVE NE ALBUQUERQUE, NM 87102 LOVELACE WESTSIDE HOSPITAL - (Acute Care) 10501 GOLF COURSE ROAD NW ALBUQUERQUE, NM 87114 LOVELACE WOMEN'S HOSPITAL - (Acute Care) 4701 MONTGOMERY BOULEVARD NE ALBUQUERQUE, NM 87109

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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JEROME W BACA, PA-C – NPI #1811243462Medical

Contact Information

Specialty

Medical

NPI Profile & details for JEROME W BACA · (Male)

Reviews for JEROME W BACA

JEROME W BACA, PA-C – NPI #1811243462
Medical