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General NPI Number Information
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NPI Number | 1023030616
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Entity Type | Organization
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Legal Business Name | JTK CORP
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 315 W WASHINGTON SUITE D
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City | ARTESIA
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State | NM
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Zip | 88211-0855
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Country | US
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Telephone | 505-746-4540
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Fax | 505-746-4295
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Provider Business Mailing Address
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Address Line | PO BOX 855
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City | ARTESIA
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State | NM
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Zip | 88211-0855
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Country | US
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Telephone | 505-746-4540
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Fax | 505-746-4295
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOE P SALGADO
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Credential | MD
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Telephone | 505-746-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 99297
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License Number State | NM
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