Basic Information
| Provider Information | |||||||||
| NPI: | 1831291590 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | QUINTANA | ||||||||
| FirstName: | J GEORGE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF NEUROLOGY | ||||||||
| Address2: | MSC 105620, 1 UNIVERSITY OF NEW MEXICO | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052723342 | ||||||||
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| Practice Location | |||||||||
| Address1: | DEPARTMENT OF NEW MEXICO | ||||||||
| Address2: | MSC 105620, 1 UNIVERSITY OF NEW MEXICO | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052723342 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2006 | ||||||||
| LastUpdateDate: | 06/09/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MD2004-0093 | NM | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | 49580 | WI | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.