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Clovis Dermatology Pa
Specialist in Clovis, New Mexico
NPI 1396906988

Clovis Dermatology Pa is a Specialist based in Clovis, NM. Clovis Dermatology Pa practices in Clovis, NM. The NPI Number for Clovis Dermatology Pa is 1396906988 and holds a License No. A101294 (New Mexico).

The current practice location address for Clovis Dermatology Pa is 818 Parkland Dr, Clovis, NM and can be reached out via phone at 575-762-8890.

Location: 818 Parkland Dr, Clovis, NM, 88101-4431
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1396906988
Provider Name
Clovis Dermatology Pa
Credential
Provider Entity Type
Organization
Address
818 Parkland Dr, Clovis, NM, 88101-4431
Phone Number
575-762-8890
Fax Number
Provider Enumeration Date
06/17/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NM024070 01 NM BLUE CROSS BLUE SHIELD
202005741 01 NM PRESBYTERIAN HEALTH PLAN
institution
Provider Business Practice Location Address Details
Address
818 Parkland Dr
City
Clovis
State
New Mexico
Zip
88101-4431
Phone Number
575-762-8890
Fax Number
person
Provider Business Mailing Address Details
Address
818 Parkland Dr
City
Clovis
State
New Mexico
Zip
88101-4431
Phone Number
575-762-8890
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
A101294 (New Mexico)
Definition
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.
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