Healthcare Provider Details

I. General information

NPI: 1568987758
Provider Name (Legal Business Name): ABI JAMES MD, FACS, DABOM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 FAIRWAY TER N STE B
CLOVIS NM
88101-3060
US

IV. Provider business mailing address

233 FAIRWAY TER N STE B
CLOVIS NM
88101-3060
US

V. Phone/Fax

Practice location:
  • Phone: 575-762-7779
  • Fax: 575-762-3526
Mailing address:
  • Phone: 575-762-7779
  • Fax: 575-762-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD2023-1386
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: