Individual
JEFFREY ALAN FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S.
Contact information
Practice address
1600 N MAIN AVE, LOVINGTON, NM 88260-2813
(575) 396-6611
Mailing address
113 EAGLE CREEK RANCH BLVD, FLORESVILLE, TX 78114
(210) 307-8051
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12726
TX
207Y00000X
Otolaryngology Physician
MD064495L
PA
207Y00000X
Otolaryngology Physician
Primary
MD2022-1352
NM
207Y00000X
Otolaryngology Physician
P3319
TX
Other
Enumeration date
11/01/2005
Last updated
11/15/2022
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