Individual
MR. JOHN D YERXA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2743B HWY 35N, MIMBRES, NM 88049
(575) 536-3990
(575) 536-3991
Mailing address
530 DE MOSS ST, LORDSBURG, NM 88045-2618
(575) 542-8384
(575) 542-8367
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2007-0006
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57372764
—
NM
01
—
NM300066
MEDICARE PTAN
—
Enumeration date
04/04/2007
Last updated
11/24/2008
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