Organization Name: | US MEDGROUP, P.A. ( NEW MEXICO) |
NPI Number: | 1740477306 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | W TOM FOGARTY (EVP, CMO) |
Mailing Address: | 7401 Church Ranch Blvd Suite 202 Westminister |
State: | CO US |
Postal Code: | 80021 |
Phone Number: | 8008588599 |
Fax Number: | 3037442212 |
NPI Enumeration Date: | 09/27/2007 |
NPI Last Update Date: | 05/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |