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General NPI Number Information
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NPI Number | 1649242348
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Entity Type | Individual
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Provider Name | PETER TEMPEST MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 516 EAST NIZHONI BLVD.
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City | GALLUP
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State | NM
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Zip | 87301-1337
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Country | US
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Telephone | 505-722-1000
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Fax | 505-722-1650
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Provider Business Mailing Address
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Address Line | PO BOX 1337
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City | GALLUP
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State | NM
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Zip | 87305-1337
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Country | US
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Telephone | 505-722-1000
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Fax | 505-722-1650
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 96-148
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License Number State | NM
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