Healthcare Provider Details

I. General information

NPI: 1457686511
Provider Name (Legal Business Name): BAYLE R. CURTIS P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 10/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 MORNINGRISE PL SE
ALBUQUERQUE NM
87108-4520
US

IV. Provider business mailing address

1806 MORNINGRISE PL SE
ALBUQUERQUE NM
87108-4520
US

V. Phone/Fax

Practice location:
  • Phone: 505-363-8336
  • Fax:
Mailing address:
  • Phone: 505-363-8336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2009-0026
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: