Individual
MATTHEW EMERSON KAISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
702 N 13TH ST, ARTESIA, NM 88210
(575) 746-3119
(575) 748-8524
Mailing address
702 N 13TH ST, ARTESIA, NM 88210-1166
(575) 746-3119
(575) 748-8524
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601007593
MI
363AM0700X
Medical Physician Assistant
Primary
PA2018-0044
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1130317
NCCPA ID
MI
01
—
5601007593
MI PA LICENSE PERMANENT ID
MI
01
—
PA2018-0044
NM PA LICENCING BOARD
NM
Enumeration date
12/23/2015
Last updated
11/08/2024
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