Organization
CLOVIS DERMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD J BROWN D.O. (OWNER/PHYSICIAN)
(575) 762-8890
Entity
Organization
Contact information
Practice address
818 PARKLAND DR, CLOVIS, NM 88101-4431
(575) 762-8890
Mailing address
818 PARKLAND DR, CLOVIS, NM 88101-4431
(575) 762-8890
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A101294
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202005741
PRESBYTERIAN HEALTH PLAN
NM
01
—
NM024070
BLUE CROSS BLUE SHIELD
NM
Enumeration date
06/17/2008
Last updated
06/17/2008
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