IndividualActive
Douglas North, PA-C
NPI 1720071186 · Medical Physician Assistant · Penasco, NM
Provider details
- NPI number
- 1720071186
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- 2001-PA27 (NM)
Practice location
15136 St. Rd. 75
Penasco, NM 87553-0238
Phone: (575) 587-2205
Fax: (575) 587-1944
Mailing address
Po Box 158
Espanola, NM 87532-0158
Registry dates
- Enumerated
- 2005-08-31
- Last updated
- 2013-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.