Provider Demographics
NPI:1588707905
Name:DAVID AND JANE CUMMINGS
Entity type:Organization
Organization Name:DAVID AND JANE CUMMINGS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-534-3004
Mailing Address - Street 1:PO BOX 2137
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-2137
Mailing Address - Country:US
Mailing Address - Phone:505-534-3004
Mailing Address - Fax:505-534-3017
Practice Address - Street 1:2600 N SILVER ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-7201
Practice Address - Country:US
Practice Address - Phone:505-534-3004
Practice Address - Fax:505-534-3017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty