Mr. Earl Douglas Bourgoyne
Orthotic Fitter
1501 San Pedro Dr Se
Albuquerque
, New Mexico 87108-5153
Mr. Earl Douglas Bourgoyne
Orthotic Fitter
1501 San Pedro Dr Se
Albuquerque
, New Mexico 87108-5153
(505) 891-9210
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About
Features
Specialties
- Orthotic Fitter
Languages spoken
- English
Location
First Address
- Mr. Earl Douglas Bourgoyne
- 617 Rio Hondo Rd Ne
- Rio Rancho, NM
- Zip : 87144-4717
- Phone : (505) 891-9210
Second Address
- Mr. Earl Douglas Bourgoyne
- 1501 San Pedro Dr Se
- Albuquerque, NM
- Zip : 87108-5153
- Phone : (505) 256-2756
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Is Mr. Earl Douglas Bourgoyne a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225000000X | Orthotic Fitter |
National Provider Identifier
| NPI | 1114937000 |
|---|---|
| Provider Name | Mr. Earl Douglas Bourgoyne |
| First Address | Rio Rancho, NM 87144-4717 |
| Second Address | Albuquerque, NM 87108-5153 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.