Provider Demographics
NPI:1538324488
Name:HIGH DESERT DOPPLER
Entity Type:Organization
Organization Name:HIGH DESERT DOPPLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KENNETH AYER
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:RVT
Authorized Official - Phone:505-350-3397
Mailing Address - Street 1:9501 LA PLAYA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3409
Mailing Address - Country:US
Mailing Address - Phone:505-350-3397
Mailing Address - Fax:
Practice Address - Street 1:9501 LA PLAYA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3409
Practice Address - Country:US
Practice Address - Phone:505-350-3397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty