Healthcare Provider Details

I. General information

NPI: 1891947206
Provider Name (Legal Business Name): B.G.HEWETT & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 N DATE ST
TRUTH OR CONSEQUENCES NM
87901-2346
US

IV. Provider business mailing address

518 N DATE ST
TRUTH OR CONSEQUENCES NM
87901-2346
US

V. Phone/Fax

Practice location:
  • Phone: 575-894-7811
  • Fax: 575-894-9458
Mailing address:
  • Phone: 575-894-7811
  • Fax: 575-894-9458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BERNIE G. HEWETT
Title or Position: OWNER
Credential: M.D.
Phone: 575-894-7811