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Individual

GERALD E BOONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA CERTIFIED PAC

Contact information

Practice address
301 S ROSELAWN, ARTESIA, NM 88210
(575) 746-3616
(575) 748-2544
Mailing address
301 S ROSELAWN, ARTESIA, NM 88210
(575) 746-3616
(575) 748-2544

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA065
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
72094
NM
01
NMEX PA 065
NMEX PA 065
NM
Enumeration date
10/02/2006
Last updated
01/25/2010
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