Individual
DR. LINDA DAVIS MAWHORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-8005
(719) 589-8023
Mailing address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-3000
(719) 587-1372
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27349
CO
207RI0200X
Infectious Disease Physician
27349
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83126058
—
CO
01
—
840255530038
ROCKY MTN HEALTH PLANS
CO
01
—
P00255204
MEDICARE RAILROAD CARRIER
CO
Enumeration date
12/06/2005
Last updated
02/05/2008
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