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General NPI Number Information
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NPI Number | 1104856640
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Entity Type | Individual
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Provider Name | JONATHAN CALDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 09/11/2017
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Provider Practice Location Address
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Address Line | JUNCTION NAVAJO ROUTE 9, HIGHWAY 371
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City | CROWNPOINT
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State | NM
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Zip | 87313-0358
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Country | US
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Telephone | 505-786-5291
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Fax | 505-786-6440
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Provider Business Mailing Address
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Address Line | PO BOX 358
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City | CROWNPOINT
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State | NM
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Zip | 87313-0358
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Country | US
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Telephone | 505-786-5291
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Fax | 505-786-6440
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C53578
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD181900
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | NM-2001-146
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M-12484
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License Number State | ID
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