Ethan A Prairie, MD
NPI #1134749195 in Rio Rancho, New Mexico
Provider Information
- NPI Number
- 1134749195
- Entity Type
- Individual
- Name
- Ethan A Prairie, MD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Family Medicine
- Credential
- MD
- Enumeration Date
- Apr 20, 2020
- Last Updated
- Dec 29, 2023
Practice Location
- Address
- 4005 HIGH RESORT BLVD SE
- City
- Rio Rancho
- State
- New Mexico
- ZIP Code
- 87124-5906
- Phone
- (505) 462-6000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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