John Smith, B.S. , D.O.M.
Individual provider Active NPI Acupuncturist · El Prado, NM
NPI 1952524902 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1952524902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- #028 (NM)
- Practice address
- 251 Lower Las Colonias Rd.
El Prado, NM 87529 - Phone
- (505) 758-2038
- NPI assigned
- Apr 10, 2007
- 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)
- No
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #028 | NM | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | #028 | NM | Yes |
Addresses
Primary practice location
251 Lower Las Colonias Rd.
El Prado, NM 87529
Mailing address
4396 Ndcbu
Taos, NM 87571-6016
Phone (505) 758-2038
Other providers in El Prado, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.