JEROME WAYNE BACA

ALBUQUERQUE, NM
NPI1811243462
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: NM  PA2012-0025)
Enumeration Date2012-08-01
Last Update Date2019-11-07
Business Address
JEROME WAYNE BACA PA-C
6701 JEFFERSON ST NE
ALBUQUERQUE, NM 87109
Phone number: 505-727-6200
Mailing Address
JEROME WAYNE BACA PA-C
6701 JEFFERSON ST NE
ALBUQUERQUE, NM 87109-4318
Phone number: 505-727-6200