Thomas Earl Himelick PA-C, MMSC

NPI 1073840930 - Physician Assistant - 363A00000X

NPI Details
NPI 1073840930
Gender Male
Enumeration Date 11/12/2009
Last Updated 07/31/2013
Entity Type Individual
Active Over 7 years ago
Practice Location
1217 BONITA ST
WESTERN NM MEDICAL GROUP - GRANTS
GRANTS NM, 87020-2103, US
Phone (505) 287-2958
Fax (505) 287-2403
Business Location
1217 BONITA ST
WESTERN NM MEDICAL GROUP - GRANTS
GRANTS NM, 87020-2103, US
Phone (505) 287-2958
Fax (505) 287-2403
Toxanomy
Taxonomy Code 363A00000X
License State New Mexico
License Number PA2002-0034
Remove 1073840930 NPI Number
 

According to our database, Mr. Thomas Earl Himelick PA-C, MMSC NPI is 1073840930, taxonomy code is 363A00000X and license number is PA2002-0034, license state is located at New Mexico. Thomas Earl Himelick PA-C, MMSC physically located at 1217 Bonita St, Grants NM, 87020-2103. NPI Number Thomas Earl Himelick PA-C, MMSC has the Individual type.

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1073840930 NPI number is provided on an as is basis without warranty of any kind. 1073840930 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas Earl Himelick PA-C, MMSC are for informational purposes only.