Kettwich, Donald Lee
Kettwich, Donald Lee is an sole proprietor health care provider with primary practice located at 711 Encino Pl Ne Suite E, Albuquerque NM 87102-2619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Kettwich, Donald Lee can be contacted via phone (505) 245-5737.Contact Information
Primary practice address
711 Encino Pl Ne Suite E
Albuquerque NM 87102-2619
Phone: (505) 245-5737
Fax: (505) 245-5739
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 76-208 | New Mexico |
Profile Details
| NPI number | 1124179486 |
|---|---|
| LBN Legal business name | Kettwich, Donald Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 15th, 2007 |
| Last updated | May 23rd, 2008 - about 17 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 | 1124179486 | NPPES |
| New Mexico | MEDICAID | 00015941 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 00NM019E05 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 201005185 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 | |
| New Mexico | Other | 85-0284119 |
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