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General NPI Number Information
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NPI Number | 1992196612
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Entity Type | Individual
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Provider Name | JOHN KENNETH AYER JAIN JR. RVT
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Gender | Male
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 9501 LA PLAYA ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3409
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Country | US
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Telephone | 505-350-3397
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Fax | 505-323-7980
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Provider Business Mailing Address
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Address Line | 9501 LA PLAYA ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3409
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Country | US
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Telephone | 505-350-3397
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Fax | 505-323-7980
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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 | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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