Individual provider · NPI-1

Jack B Fralinger, M.D.

Surgery · Gallup, NM

NPI number1285740118
StatusActive
Last updated in NPPESApr 3, 2012

Details

NPI
1285740118
Entity type
Individual (NPI-1)
Name
Jack B Fralinger
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 22, 2006
Last updated
Apr 3, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X SurgeryMD00038967WAYes

Practice location

516 E. Nizhoni Blvd.
Gallup, NM 87301-1337

Phone 505-722-1000 · Fax 505-722-1226

Mailing address

P.O. Box 1337
Gallup, NM 87301-1337

Phone 505-722-1000 · Fax 505-722-1226

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