Individual
MR. SIDNEY CLYDE ENGLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
402 W COUNTRY CLUB RD, ROSWELL, NM 88201-5247
(575) 627-9500
(575) 627-9535
Mailing address
PO BOX 1574, ROSWELL, NM 88202-1574
(575) 627-9110
(575) 627-4127
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA01205
TX
363AM0700X
Medical Physician Assistant
Primary
PA2013-0094
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932187044
GROUP NPI
NM
01
—
800521089
MCR GROUP KYMERA
NM
01
—
PA01205
TX LICENSE NUMBER
TX
01
—
PA2013-0094
NM PROVIDER LICENSE
NM
01
—
Z2565
MCD GROUP KYMERA
NM
Enumeration date
01/04/2006
Last updated
05/15/2014
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