Provider Demographics
NPI:1053387282
Name:NAYLOR, HUGH EDWARD III (HUGH NAYLOR MD)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:EDWARD
Last Name:NAYLOR
Suffix:III
Gender:M
Credentials:HUGH NAYLOR MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:190 HOSPITAL DRIVE
Mailing Address - Street 2:P.O. BOX 668
Mailing Address - City:RATON
Mailing Address - State:NM
Mailing Address - Zip Code:87740-0668
Mailing Address - Country:US
Mailing Address - Phone:505-445-5563
Mailing Address - Fax:505-445-5566
Practice Address - Street 1:190 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:RATON
Practice Address - State:NM
Practice Address - Zip Code:87740-2002
Practice Address - Country:US
Practice Address - Phone:505-445-5563
Practice Address - Fax:505-445-5566
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM 79-237207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2725Medicaid
NM2127446Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NMD35860Medicare UPIN