Individual
JON A SPAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1397 WEIMER RD, TAOS, NM 87571-6253
(575) 758-8883
(303) 468-1394
Mailing address
12687 W CEDAR DR, 200, LAKEWOOD, CO 80228-2014
(303) 468-1395
(303) 468-1394
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
85-291
NM
2085R0204X
Vascular & Interventional Radiology Physician
85-291
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001634
LOVELACE HEALTH/SALUD
NM
05
—
13797
—
NM
01
—
201009513
PRESBYTERIAN HEALTH/SALUD
NM
05
—
293431
—
AZ
01
—
NM009U95
BCBS
NM
01
—
P00218005
RAILROAD MEDICARE
—
01
—
PROVP16183
MOLINA
NM
Enumeration date
02/03/2006
Last updated
01/02/2020
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