Jacob, Sodaran P

Jacob, Sodaran P is an individual health care provider with primary practice located at 801 W Maple St , Farmington NM 87401-5630. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Jacob, Sodaran P can be contacted via phone (505) 609-6463.

Contact Information

Primary practice address
801 W Maple St Farmington NM 87401-5630
Fax: (505) 609-6474
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD2006-0732 New Mexico
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD2006-0732 New Mexico

Profile Details

NPI number 1376568717
LBN Legal business name Jacob, Sodaran P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Jul 31st, 2017 - about 8 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 1376568717 NPPES
New Mexico MEDICAID 93733577

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