John, Susie A

John, Susie A is an individual health care provider with primary practice located at Us Hwy 491 North , Shiprock NM 87420. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. John, Susie A can be contacted via phone (505) 368-6401.

Contact Information

Primary practice address
Us Hwy 491 North Shiprock NM 87420
Phone: (505) 368-6401
Fax: (505) 368-6431
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 85216 New Mexico

Profile Details

NPI number 1194714956
LBN Legal business name John, Susie A
Credentials MD MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Dec 26th, 2007 - about 18 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 1194714956 NPPES
Colorado MEDICAID 30487064
Colorado MEDICAID 35568
Colorado MEDICAID 939572

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