Tempest, Bruce D.
Tempest, Bruce D. is an individual health care provider with primary practice located at 650 Vanden Bosch Pkwy #A, Gallup NM 87301-5508. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Tempest, Bruce D. can be contacted via phone (505) 726-6980.Contact Information
Primary practice address
650 Vanden Bosch Pkwy #A
Gallup NM 87301-5508
Phone: (505) 726-6980
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 70-208 | New Mexico |
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207RA0201X | 70-208 | New Mexico |
Profile Details
| NPI number | 1629040407 |
|---|---|
| LBN Legal business name | Tempest, Bruce D. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629040407 | NPPES |
| Arizona | MEDICAID | 102935 | |
| Arizona | Other | 10017955 | |
| Arizona | Other | NM001H34 | |
| Arizona | MEDICAID | S0884 | |
| Arizona | Other | PROVP15878 |
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