Provider Demographics
NPI:1396922381
Name:HECHANOVA, JONATHAN W (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:W
Last Name:HECHANOVA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:440 SAINT MICHAELS DR
Mailing Address - Street 2:CSVMG PHYSICIAN PRACTICE
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7602
Mailing Address - Country:US
Mailing Address - Phone:505-913-5227
Mailing Address - Fax:505-913-6627
Practice Address - Street 1:455 SAINT MICHAELS DR
Practice Address - Street 2:CHRISTUS ST. VINCENT INTENSIVISTS
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7601
Practice Address - Country:US
Practice Address - Phone:505-984-2600
Practice Address - Fax:505-983-7299
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2015-07-01
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NMMD2013-0303207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program