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General NPI Number Information
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NPI Number | 1194003467
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Entity Type | Organization
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Legal Business Name | ALAN R JAKINS MD PC INC
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 110 W COLLEGE BLVD STE F
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City | ROSWELL
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State | NM
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Zip | 88201-5170
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Country | US
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Telephone | 575-627-6849
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Fax | 575-627-0080
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Provider Business Mailing Address
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Address Line | 110 W COLLEGE BLVD STE F
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City | ROSWELL
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State | NM
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Zip | 88201-5170
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Country | US
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Telephone | 575-627-6849
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Fax | 575-627-0080
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Authorized Official
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Title or Position | OM
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Name | MRS. NAOMI JAKINS
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Credential |
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Telephone | 575-627-6849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 86 064
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License Number State | NM
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