Ketcham, Eric M
Ketcham, Eric M is an individual health care provider with primary practice located at 801 W Maple St , Farmington NM 87401-5630. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Ketcham, Eric M can be contacted via phone (505) 609-2000.Contact Information
Primary practice address
801 W Maple St
Farmington NM 87401-5630
Phone: (505) 609-2000
Fax: (505) 609-2259
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD2004-0044 | New Mexico |
Profile Details
| NPI number | 1134193352 |
|---|---|
| LBN Legal business name | Ketcham, Eric M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Sep 11th, 2018 - about 6 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 | 1134193352 | NPPES |
| New Mexico | MEDICAID | 72982781 |
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