person
Dr. Michael Eric Ivory, DO
General Practice Physician in Gallup, New Mexico
NPI 1952521874

Michael Eric Ivory is a General Practice Physician based in Owosso, NM. Michael Eric Ivory practices in Gallup, NM and has the professional credentials of DO. The NPI Number for Michael Eric Ivory is 1952521874 and holds a License No. 5101007170 (New Mexico).

The current practice location address for Michael Eric Ivory is 516 E. Nizhoni Blvd., Gallup, NM and can be reached out via phone at 505-722-1000 and via fax at 505-726-8740.

Location: 516 E. Nizhoni Blvd., Gallup, NM, 48867-9444
person
Provider Profile Details
NPI Number
1952521874
Provider Name
Michael Eric Ivory
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
516 E. Nizhoni Blvd., Gallup, NM, 48867-9444
Phone Number
505-722-1000
Fax Number
505-726-8740
Provider Enumeration Date
04/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
30010400 05 WI
4709700 05 MI
institution
Provider Business Practice Location Address Details
Address
516 E. Nizhoni Blvd.
City
State
Zip
87301-1337
Phone Number
505-722-1000
Fax Number
505-726-8740
person
Provider Business Mailing Address Details
Address
516 E. Nizhoni Blvd.
City
State
Zip
87301-1337
Phone Number
505-722-1000
Fax Number
505-726-8740
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
5101007170 (Michigan)
Definition
Definition to come...
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