| |
1606 Se Main St, Roswell, NM 88203-5411 | |
(575) 624-0370 | |
(575) 624-0376 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 1606 Se Main St, Roswell, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821413147 | NPI | - | NPPES |
47951 | Medicaid | NM | |
K5006 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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8801 Horizon Blvd Ne, Suite 360, Albuquerque, NM 87113-1533 Ph: (505) 828-4923 | 1606 Se Main St, Roswell, NM 88203-5411 Ph: (575) 624-0370 |