National Provider Identifier Database

CLOVIS DERMATOLOGY PA
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

CLOVIS DERMATOLOGY PA
818 PARKLAND DR
CLOVIS, NM88101-4431
Phone: 575-762-8890
Fax:
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for CLOVIS DERMATOLOGY PA

NPI Number 1396906988
Legal business name
LBN
CLOVIS DERMATOLOGY PA
Authorized official DONALD BROWN - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 06/17/2008
Last updated 06/17/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: A101294
  • NM Other: NM024070 BLUE CROSS BLUE SHIELD
  • NM Other: 202005741 PRESBYTERIAN HEALTH PLAN

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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