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Individual

FORREST E HENRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
530 DEMOSS STREET, LORDSBURG, NM 88045-2618
(575) 542-2313
(575) 542-2388
Mailing address
530 DEMOSS STREET, LORDSBURG, NM 88045-2618
(575) 542-2313
(575) 542-2388

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A-1382-06
NM
207Q00000X
Family Medicine Physician
T-252
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
67570364
NM
Enumeration date
04/12/2006
Last updated
02/14/2013
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