Provider Demographics
NPI:1407871502
Name:GARVER, JOHN ERIC (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ERIC
Last Name:GARVER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901-1961
Mailing Address - Country:US
Mailing Address - Phone:575-894-2111
Mailing Address - Fax:575-894-7659
Practice Address - Street 1:800 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1961
Practice Address - Country:US
Practice Address - Phone:575-894-2111
Practice Address - Fax:575-894-7659
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1561-10207P00000X
CO42765207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COI22887Medicare UPIN