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NPI Code Detail

MEDICARE: DR. JONNY LORRAINE SALYER M.D.

MEDICARE: DR. JONNY LORRAINE SALYER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZC0006XClinical Pathology Physician91-297NM

General Provider Information

NPI Number : 1548675473
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONNY LORRAINE SALYER M.D.
Provider Business Mailing Address
First Line : 1600 CAMINO DE LA SIERRA NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-4938
Country : US
Telephone Number : 317-910-2402
Fax Number :
Provider Business Practice Location Address
First Line : 2441 RIDGECREST DR SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-5129
Country : US
Telephone Number : 505-348-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2014
Last Update Date : 06/30/2014

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