NPI 1952521874

Michael Eric Ivory, DO

Practitioner General Practice Physician Gallup, NM

Practice location

Address: 516 E. Nizhoni Blvd., Gallup, NM 87301-1337
Phone: (505) 722-1000
Fax: (505) 726-8740
Mailing address: 4070 N Chipman St, Owosso, MI 48867-9444

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 5101007170 (MI)

Other General Practice providers in New Mexico →

Registry record

NPI: 1952521874
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Apr 2007
Record last updated: 27 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.