Provider Demographics
NPI:1720123847
Name:CHEST MEDICINE OF NEW MEXICO, PC
Entity type:Organization
Organization Name:CHEST MEDICINE OF NEW MEXICO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DORF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-821-5992
Mailing Address - Street 1:4273 MONTGOMERY BLVD NE
Mailing Address - Street 2:SUITE 200 EAST
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6748
Mailing Address - Country:US
Mailing Address - Phone:505-821-5992
Mailing Address - Fax:505-821-6692
Practice Address - Street 1:4273 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE 200 EAST
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6748
Practice Address - Country:US
Practice Address - Phone:505-821-5992
Practice Address - Fax:505-821-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty