Individual
DR. SCOTT RYAN JEANSONNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
145 DON PASQUAL RD NW, LOS LUNAS, NM 87031-8841
(505) 873-7400
Mailing address
PO BOX 912678, DENVER, CO 80291-2678
(505) 241-5182
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A-1580-10
NM
Other
Enumeration date
06/30/2009
Last updated
05/14/2025
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