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Individual

WESLEY GILMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3530 FOOTHILLS RD, LAS CRUCES, NM 88011-3626
(575) 532-6054
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2015-0037
NM
363AM0700X
Medical Physician Assistant
PA2015-0037
NM

Other

Enumeration date
07/07/2015
Last updated
05/01/2026
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