| Organization Name: | HEALTHNET MEDICAL FAMILY & INTERNAL MEDICINE |
| NPI Number: | 1851575914 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NATHANIEL L GRIFFITH (PRESIDENT) |
| Mailing Address: | 1074 Country Club Rd Bldg C Suite 1 Santa Teresa |
| State: | NM US |
| Postal Code: | 880089757 |
| Phone Number: | 5755891552 |
| Fax Number: | 5755890888 |
| NPI Enumeration Date: | 12/26/2007 |
| NPI Last Update Date: | 12/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A129705 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |