| Doctor Name: | ZHENG SONG |
| NPI Number: | 1053735340 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | MA056701 |
| Business Practice Address: | 1600 North Main Lovington, NM - 882602813 |
| Business Phone Number: | 5753966611 |
| Business Fax Number: | 5753961454 |
| Mailing Address: | 1600 North Main, LOVINGTON |
| State: | NM |
| Postal Code: | 882602813 |
| Phone Number: | 5753966611 |
| Fax Number: | 5753961454 |
| NPI Enumeration Date: | 02/07/2014 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA056701 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |