Individual
DR. JOHN B DACANAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(575) 622-6322
(575) 622-6888
Mailing address
PO BOX 2608, ROSWELL, NM 88202-2608
(575) 622-6322
(575) 622-6888
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
36091802
IL
207V00000X
Obstetrics & Gynecology Physician
37784
AZ
207V00000X
Obstetrics & Gynecology Physician
Primary
MD2012-0806
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091802
—
IL
05
—
305790
—
AZ
05
—
PENDING
—
AZ
Enumeration date
05/15/2006
Last updated
09/26/2019
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