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1811243462
JEROME WAYNE BACA
ALBUQUERQUE, NM
NPI
1811243462
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NM PA2012-0025)
Enumeration Date
2012-08-01
Last Update Date
2019-11-07
Business Address
JEROME WAYNE BACA PA-C
6701 JEFFERSON ST NE
ALBUQUERQUE, NM 87109
Phone number: 505-727-6200
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Mailing Address
JEROME WAYNE BACA PA-C
6701 JEFFERSON ST NE
ALBUQUERQUE, NM 87109-4318
Phone number: 505-727-6200
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