Healthcare Provider Details

I. General information

NPI: 1487365227
Provider Name (Legal Business Name): BRANDON MCAFEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 12/13/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 3RD STREET
SPRINGER NM
87747
US

IV. Provider business mailing address

PO BOX 446
SPRINGER NM
87747-0446
US

V. Phone/Fax

Practice location:
  • Phone: 505-808-5576
  • Fax: 575-483-7190
Mailing address:
  • Phone: 505-808-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: