Healthcare Provider Details

I. General information

NPI: 1346203346
Provider Name (Legal Business Name): JOHN HARMSTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN HARMSTON MD

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 05/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5419 N LOVINGTON HWY STE 15
HOBBS NM
88240-9100
US

IV. Provider business mailing address

2430 W PIERCE ST
CARLSBAD NM
88220-3553
US

V. Phone/Fax

Practice location:
  • Phone: 575-392-5191
  • Fax: 575-392-0008
Mailing address:
  • Phone: 575-628-5051
  • Fax: 575-628-0493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number80169
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: