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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407004583 | NPPES |
| New Mexico | MEDICAID | 27071383 |
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