Healthcare Provider Details

I. General information

NPI: 1588707905
Provider Name (Legal Business Name): DAVID AND JANE CUMMINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N SILVER ST
SILVER CITY NM
88061-7201
US

IV. Provider business mailing address

PO BOX 2137
SILVER CITY NM
88062-2137
US

V. Phone/Fax

Practice location:
  • Phone: 505-534-3004
  • Fax: 505-534-3017
Mailing address:
  • Phone: 505-534-3004
  • Fax: 505-534-3017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JANE KRUSE
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-534-3004