Basic Information
Provider Information
NPI: 1831104397
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CLOKEY
FirstName: DIANA
MiddleName:  
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NameSuffix:  
Credential: LD, RPH, CDE
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Mailing Information
Address1: 933 BRADBURY SE
Address2: SUITE 2222
City: ALBUQUERQUE
State: NM
PostalCode: 871064375
CountryCode: US
TelephoneNumber: 5052723120
FaxNumber: 5052728060
Practice Location
Address1: 2211 LOMAS BLVD. NE
Address2: 4TH FLOOR AMBULATORY CARE CTR
City: ALBUQUERQUE
State: NM
PostalCode: 87106
CountryCode: US
TelephoneNumber: 5052722245
FaxNumber: 5052721109
Other Information
ProviderEnumerationDate: 07/30/2006
LastUpdateDate: 01/31/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VM0101X385NMY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

No ID Information.


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