Provider Demographics
NPI:1194753533
Name:ALFORD, ALMA JULIA (MD)
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:JULIA
Last Name:ALFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1337
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87305-1337
Mailing Address - Country:US
Mailing Address - Phone:505-722-1000
Mailing Address - Fax:505-726-8740
Practice Address - Street 1:516 E. NIZHONI BLVD.
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-1337
Practice Address - Country:US
Practice Address - Phone:505-722-1000
Practice Address - Fax:505-726-8740
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000S0375Medicaid
AZ414938Medicaid
TX8HZ160Medicare ID - Type UnspecifiedHSZ002
TX8HBT72Medicare ID - Type UnspecifiedHSZ197
TX8HZ152Medicare ID - Type UnspecifiedHSZ006
H37697Medicare UPIN
NM000S0375Medicaid
TX8HZ036Medicare ID - Type UnspecifiedHSZ003
AZ414938Medicaid