Individual
KENNETH S HIMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5757 HARPER DRIVE NE, ALBUQUERQUE, NM 87109
(505) 888-5757
(505) 889-3589
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 828-4923
(505) 213-0103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD2006-0146
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115638
—
AZ
05
—
70308233
—
NM
01
—
NM001H33
BC BS OF NM
NM
01
—
P00343296
RRB MEDICARE RAILROAD
NM
Enumeration date
04/14/2006
Last updated
04/25/2008
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