Acevedo Gonzalez, Jacqueline

Acevedo Gonzalez, Jacqueline is an individual health care provider with primary practice located at 1515 West Fir , Portales NM 88130-0843. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Acevedo Gonzalez, Jacqueline can be contacted via phone (575) 356-6695.

Contact Information

Primary practice address
1515 West Fir Portales NM 88130-0843
Phone: (575) 356-6695
Fax: (575) 356-5948
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD2008-0680 New Mexico

Profile Details

NPI number 1407004583
LBN Legal business name Acevedo Gonzalez, Jacqueline
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2008
Last updated Aug 11th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407004583 NPPES
New Mexico MEDICAID 27071383

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