Provider Demographics
NPI:1528184421
Name:JOCHEMS, GREGORY E (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:E
Last Name:JOCHEMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-6770
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:PMG HIGH RESORT 4005
Practice Address - Street 2:4005 HIGH RESORT BLVD
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124
Practice Address - Country:US
Practice Address - Phone:505-462-6000
Practice Address - Fax:505-462-8686
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM94-274208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM16107Medicaid
NM16107Medicaid
NM16107Medicaid