Healthcare Provider Details

I. General information

NPI: 1407871502
Provider Name (Legal Business Name): JOHN ERIC GARVER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 9TH AVE
TRUTH OR CONSEQUENCES NM
87901-1961
US

IV. Provider business mailing address

800 E 9TH AVE
TRUTH OR CONSEQUENCES NM
87901-1961
US

V. Phone/Fax

Practice location:
  • Phone: 575-894-2111
  • Fax: 575-894-7659
Mailing address:
  • Phone: 575-894-2111
  • Fax: 575-894-7659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA-1561-10
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42765
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: