Provider Demographics
NPI:1265929244
Name:COMMISKEY, PATRICK WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:WILLIAM
Last Name:COMMISKEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8801 HORIZON BLVD NE STE 360
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1563
Mailing Address - Country:US
Mailing Address - Phone:505-828-4923
Mailing Address - Fax:505-213-0103
Practice Address - Street 1:5757 HARPER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3566
Practice Address - Country:US
Practice Address - Phone:505-888-5757
Practice Address - Fax:505-875-0160
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2023-0234207W00000X
MDD94163207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM25886886Medicaid
NM2T6568OtherMEDICARE PTAN