Individual
DR. PAUL A MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 325-5011
(505) 324-2258
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2000
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2005-0318
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10023500
LOVELACE
—
05
—
64731553
—
NM
Enumeration date
05/30/2006
Last updated
12/19/2025
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