| Advanced Gastroenterology Associates | |
|
4801 N Butler Ave Suite 13102 Farmington NM 87401-6002 | |
| (505) 436-2906 | |
| (505) 436-2197 |
| Full Name | Advanced Gastroenterology Associates |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 4801 N Butler Ave, Farmington, New Mexico |
| Authorized Official Name and Position | Autumn L Roberts (PRACTICE MANAGER) |
| Authorized Official Contact | 5054362906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Gastroenterology Associates 4801 N Butler Ave Suite 13102 Farmington NM 87401-6002 Ph: (505) 436-2906 | Advanced Gastroenterology Associates 4801 N Butler Ave Suite 13102 Farmington NM 87401-6002 Ph: (505) 436-2906 |
| NPI Number | 1184985475 |
|---|---|
| Provider Enumeration Date | 06/03/2012 |
| Last Update Date | 04/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184985475 | NPI | - | NPPES |
| DT4411 | Other | NM | RR MCR |
| 792536 | Other | NM | AHCCCS |
| 30177880 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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