Individual
DR. JOSEPH D'ANTONIO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4351 E LOHMAN AVE STE 201, LAS CRUCES, NM 88011-8260
(575) 522-2233
(575) 522-2266
Mailing address
4351 E LOHMAN AVE STE 201, LAS CRUCES, NM 88011-8260
(575) 522-2233
(575) 522-2266
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
D0022409
MD
207RC0000X
Cardiovascular Disease Physician
Primary
MD2012-0524
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19072767
—
NM
01
—
NMA102546
MEDICARE PTAN
NM
Enumeration date
06/01/2006
Last updated
09/08/2020
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