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Jerome Wayne Baca, PA-C
Medical Physician Assistant in Albuquerque, New Mexico
NPI 1811243462

Jerome Wayne Baca is a Medical Physician Assistant based in Albuquerque, NM and is specialized in Medical. Jerome Wayne Baca practices in Albuquerque, NM and has the professional credentials of PA-C. The NPI Number for Jerome Wayne Baca is 1811243462 and holds a License No. PA2012-0025 (New Mexico).

The current practice location address for Jerome Wayne Baca is 6701 Jefferson St Ne, Albuquerque, NM and can be reached out via phone at 505-727-6200 and via fax at 505-727-9590.

Location: 6701 Jefferson St Ne, Albuquerque, NM, 87109-4318
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Provider Profile Details
NPI Number
1811243462
Provider Name
Jerome Wayne Baca
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
6701 Jefferson St Ne, Albuquerque, NM, 87109-4318
Phone Number
505-727-6200
Fax Number
505-727-9590
Provider Enumeration Date
08/01/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
64471870 05 NM
PA2012-0025 01 NM NM MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
6701 Jefferson St Ne
City
State
Zip
87109
Phone Number
505-727-6200
Fax Number
505-727-9590
person
Provider Business Mailing Address Details
Address
6701 Jefferson St Ne
City
State
Zip
87109
Phone Number
505-727-6200
Fax Number
505-727-9590
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA2012-0025 (New Mexico)
Definition
Definition to come...
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