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Organization

KIM P LARK DO PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CHRISTI MICHELLE YERBY (BILLING SPECIALIST)
(505) 234-9964
Entity
Organization

Contact information

Practice address
2402 W PIERCE ST, STE 4A, CARLSBAD, NM 88220-3537
(505) 234-9964
(505) 234-9962
Mailing address
2402 W PIERCE ST, STE 4A, CARLSBAD, NM 88220-3537
(505) 234-9964
(505) 234-9962

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A110698
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00T9592
NM
01
NM004378
BCBS
NM
Enumeration date
09/27/2007
Last updated
11/12/2007
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