Provider Demographics
NPI:1417950460
Name:GARCIA, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1631 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4728
Mailing Address - Country:US
Mailing Address - Phone:505-424-0200
Mailing Address - Fax:505-424-6608
Practice Address - Street 1:1631 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4728
Practice Address - Country:US
Practice Address - Phone:505-424-0200
Practice Address - Fax:505-424-6608
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2003001211207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
7135504OtherAETNA
9274OtherEXCLUSIVE CHOICE
2305584OtherUHC
43511OtherHEALTHCARE USA
5729197OtherCIGNA
179426OtherBLUE CROSS BLUE SHIELD
351240001OtherCIGNA DMERC
561510OtherHEALTHLINK
5729197OtherCIGNA