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Individual

SUSAN FAYTHE GOWING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
4351 E LOHMAN AVE, SUITE 405, LAS CRUCES, NM 88011-8259
(575) 521-0121
(575) 532-5949
Mailing address
1923 WINDSOR PL, LAS CRUCES, NM 88005-1683
(575) 312-9077
(575) 647-2938

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
78-PA003
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
98853
NM
Enumeration date
06/21/2005
Last updated
10/17/2007
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