Individual provider · NPI-1

Jan A Gotta, M.D.

Anesthesiology · Farmington, NM

NPI number1265405302
StatusActive
Last updated in NPPESDec 10, 2009

Details

NPI
1265405302
Entity type
Individual (NPI-1)
Name
Jan A Gotta
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Feb 9, 2006
Last updated
Dec 10, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207L00000X AnesthesiologyMD2004-0691NMYes

Practice location

801 W Maple St
Farmington, NM 87401-5630

Phone 505-326-6400 · Fax 505-326-4606

Mailing address

1515 E 20th St
Suite A
Farmington, NM 87401-9039

Phone 505-326-6400 · Fax 505-326-4606

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