Individual
DR. AHMAD H OTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
233 FAIRWAY TER N STE B, CLOVIS, NM 88101-3060
(575) 762-7779
(575) 762-3526
Mailing address
2508 FAIRWAY TER, CLOVIS, NM 88101-2734
(312) 813-6958
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2018-0173
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12875279
—
NM
Enumeration date
08/09/2012
Last updated
06/08/2021
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