Individual
JOHN M. MEZOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
231 NIZHONI BLVD, GALLUP, NM 87301-5792
(505) 722-2268
(505) 863-2874
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
80-67
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13649
—
NM
01
—
180014478
RRB MEDICARE RAILROAD
NM
05
—
239930
—
AZ
01
—
NM001869
BC BS OF NM
NM
Enumeration date
10/21/2005
Last updated
04/25/2008
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