Claycomb, Jennifer Lea Lea

Claycomb, Jennifer Lea Lea is an individual health care provider with primary practice located at 500 North Mundo , Dulce NM 87528-0187. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Claycomb, Jennifer Lea Lea can be contacted via phone (505) 759-3291.

Contact Information

Primary practice address
500 North Mundo Dulce NM 87528-0187
Phone: (505) 759-3291
Fax: (505) 759-3532
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2005019602 Missouri

Profile Details

NPI number 1144323353
LBN Legal business name Claycomb, Jennifer Lea Lea
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated May 25th, 2011 - about 15 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 1144323353 NPPES
New Mexico MEDICAID 000K3526
New Mexico MEDICAID 01929259
New Mexico Other HSZ196
New Mexico Other 8HN171

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