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1808 E Aztec Ave Ste 6 Gallup NM 87301-4946 | |
(505) 863-9374 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 1808 E Aztec Ave Ste 6, Gallup, New Mexico |
Authorized Official Name and Position | Marian Mckenzie (BUSINESS MANAGER) |
Authorized Official Contact | 5058639374 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1808 E Aztec Ave Ste 6 Gallup NM 87301-4946 Ph: (505) 863-9374 | 1808 E Aztec Ave Ste 6 Gallup NM 87301-4946 Ph: (505) 863-9374 |
NPI Number | 1316135510 |
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Provider Enumeration Date | 10/12/2007 |
Last Update Date | 11/15/2010 |
Identifier | Type | State | Issuer |
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1316135510 | NPI | - | NPPES |
11858 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Gallup Quick Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 E Highway 66, Gallup, NM 87301 Phone: 505-722-9334 Fax: 505-722-9352 | |
Legacy Family Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1808 E Aztec Ave Ste 6, Gallup, NM 87301 Phone: 505-863-9374 | |