MEDICARE: HIGH DESERT DOPPLER INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	293D00000X	Physiological Laboratory

General Provider Information

NPI Number	:	1326605775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGH DESERT DOPPLER INC.

Provider Business Mailing Address
First Line	:	3825 EUBANK BLVD NE STE H
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3559
Country	:	US
Telephone Number	:	505-350-3397
Fax Number	:	505-323-7980

Provider Business Practice Location Address
First Line	:	3825 EUBANK BLVD NE STE H
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3559
Country	:	US
Telephone Number	:	505-350-3397
Fax Number	:	505-323-7980

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN KENNETH AYER JAIN JR.
Credential	:	RVT
Telephone Number	:	505-350-3397

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	06/10/2022

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Directions to “HIGH DESERT DOPPLER INC. ” Practice Location

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