Gordon Battle Eatman, D.C.

Individual provider Active NPI Chiropractor · Cedar Crest, NM

NPI 1669559258 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1669559258
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
577 (NM)
Practice address
49 Los Lomas Cir
Cedar Crest, NM 87008-9308
Phone
(505) 286-8067
Fax
(505) 286-8067
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 577 NM Yes

Addresses

Primary practice location

49 Los Lomas Cir
Cedar Crest, NM 87008-9308

Mailing address

49 Los Lomas Cir
Cedar Crest, NM 87008-9308
Phone (505) 286-8067

Other identifiers

IdentifierTypeStateIssuer
000K6164MedicaidNM

Other providers in Cedar Crest, NM

All providers in Cedar Crest, NM · Chiropractor in New Mexico

Sources for this page

Verify at the official NPI Registry.