Djrj3 Medical Services Inc
Organization Active NPI Obstetrics & Gynecology Physician · Grants, NM
NPI 1922045319 · NPPES record last updated Apr 3, 2015
Key facts
- NPI
- 1922045319
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- MD2013-0395 (NM)
- Legal business name
- DJRJ3 MEDICAL SERVICES INC
- Practice address
- 840 Lobo Canyon Rd
Grants, NM 87020-2172 - Phone
- (505) 404-9132
- Fax
- (505) 393-1076
- NPI assigned
- Jun 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Joseph M Charles Jr., MD
- Title
- Owner
- Phone
- (505) 404-9132
National Provider Directory
Locations
1037 W US Highway 90
Lake City, FL 32055
Phone (386) 752-3445
4225 NW American Ln
Lake City, FL 32055
Phone (386) 755-9190
484 SW Commerce Dr
Ste 105
Lake City, FL 32025
Phone (386) 755-9190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | MD2013-0395 | NM | Yes |
Addresses
Primary practice location
840 Lobo Canyon Rd
Grants, NM 87020-2172
Mailing address
PO Box 7191
Grants, NM 87020-7191
Phone (505) 404-9132
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 274840100 | Medicaid | FL | |
| 10-8990 | Other | FL | RURAL HEALTH CLINIC PROVI |
| 660226600 | Medicaid | FL | |
| 80574271 | Medicaid | NM |
Other names
- DJRJ2
Other providers in Grants, NM
- Donna Deming
- Derrick Baca DDS LLC
- Desert Rain Personal Care, LLC
- Dialysis Clinic Inc.
- Stacey Dimitt
- Dr Alexander L.L.C
- Ducasse Chiropractic Inc
- Rose A Ducasse
- Liberty Hayla-Marie Duenas
- Dungarvin New Mexico, LLC
All providers in Grants, NM · Obstetrics & Gynecology Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.