Healthcare Provider Details

I. General information

NPI: 1003926163
Provider Name (Legal Business Name): WILLIAM GARY MCFARLAND PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 INDIAN SCHOOL RD NE STE 200
ALBUQUERQUE NM
87110-4968
US

IV. Provider business mailing address

PO BOX 1861
TIJERAS NM
87059-1861
US

V. Phone/Fax

Practice location:
  • Phone: 505-875-7357
  • Fax: 505-286-7442
Mailing address:
  • Phone: 505-286-4502
  • Fax: 505-286-7442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number600
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: