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Organization
KIM P LARK DO PC
Active
Organization
KIM P LARK DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTI MICHELLE YERBY (BILLING SPECIALIST)
(505) 234-9964
Entity
Organization
Contact information
Practice address
2402 W PIERCE ST, STE 4A, CARLSBAD, NM 88220-3537
(505) 234-9964
(505) 234-9962
Mailing address
2402 W PIERCE ST, STE 4A, CARLSBAD, NM 88220-3537
(505) 234-9964
(505) 234-9962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A110698
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00T9592
—
NM
01
—
NM004378
BCBS
NM
Enumeration date
09/27/2007
Last updated
11/12/2007
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