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General NPI Number Information
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NPI Number | 1508886813
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Entity Type | Individual
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Provider Name | JAMES ROBERT DAMRON MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 31 EAGLE RDG
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City | SANTA FE
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State | NM
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Zip | 87508-5907
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Country | US
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Telephone | 505-470-7000
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Fax | 505-986-5048
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Provider Business Mailing Address
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Address Line | 31 EAGLE RDG
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City | SANTA FE
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State | NM
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Zip | 87508-5907
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Country | US
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Telephone | 505-470-7000
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Fax | 505-986-5048
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 75-131
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License Number State | NM
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