IndividualActive
Douglas Shaffer, PAC
NPI 1639225055 · Medical Physician Assistant · Farmington, NM
Provider details
- NPI number
- 1639225055
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- License
- PA20050038NM (NM)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3451 N Butler Ave
Farmington, NM 87401-2357
Phone: (505) 566-1915
Fax: (505) 566-1918
Approximate (ZIP-level) locationGet directions
Mailing address
3451 N Butler Ave
Farmington, NM 87401-2357
Registry dates
- Enumerated
- 2007-01-26
- Last updated
- 2007-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.