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1134193352
ERIC M KETCHAM
FARMINGTON, NM
NPI
1134193352
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: NM MD2004-0044)
Enumeration Date
2006-02-14
Last Update Date
2018-09-11
Business Address
ERIC M KETCHAM M.D.
801 W MAPLE ST
FARMINGTON, NM 87401-5630
Phone number: 505-609-2000
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Mailing Address
ERIC M KETCHAM M.D.
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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