person
Mr. Douglas A. North, PA-C
Medical Physician Assistant in Penasco, New Mexico
NPI 1720071186

Douglas A. North is a Medical Physician Assistant based in Espanola, NM and is specialized in Medical. Douglas A. North practices in Penasco, NM and has the professional credentials of PA-C. The NPI Number for Douglas A. North is 1720071186 and holds a License No. 2001-PA27 (New Mexico).

The current practice location address for Douglas A. North is 15136 St. Rd. 75, Penasco, NM and can be reached out via phone at 575-587-2205 and via fax at 575-587-1944.

Location: 15136 St. Rd. 75, Penasco, NM, 87532-0158
person
Provider Profile Details
NPI Number
1720071186
Provider Name
Douglas A. North
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
15136 St. Rd. 75, Penasco, NM, 87532-0158
Phone Number
575-587-2205
Fax Number
575-587-1944
Provider Enumeration Date
08/31/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
81958757 05 NM
NM400307 01 NM MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
15136 St. Rd. 75
City
State
Zip
87553-0238
Phone Number
575-587-2205
Fax Number
575-587-1944
person
Provider Business Mailing Address Details
Address
15136 St. Rd. 75
City
State
Zip
87553-0238
Phone Number
575-587-2205
Fax Number
575-587-1944
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
2001-PA27 (New Mexico)
Definition
Definition to come...
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