Individual
JOHN P MAHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
330 PASEO DEL PUEBLO SUR STE C, TAOS, NM 87571-5328
(575) 758-1414
(575) 758-1474
Mailing address
330 PASEO DEL PUEBLO SUR STE C, TAOS, NM 87571-5328
(575) 758-1414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085001767
IL
363A00000X
Physician Assistant
Primary
PA2019-0019
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17576741
—
NM
Enumeration date
12/24/2009
Last updated
07/30/2025
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