| Farmington Family Practice | |
|
622 W Maple St Suite B Farmington NM 87401-6590 | |
| (505) 327-4867 | |
| (505) 327-5355 |
| Full Name | Farmington Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 622 W Maple St, Farmington, New Mexico |
| Authorized Official Name and Position | Robert Joseph Burns (PRESIDENT) |
| Authorized Official Contact | 5053274867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Farmington Family Practice 622 W Maple St Suite B Farmington NM 87401-6590 Ph: (505) 327-4867 | Farmington Family Practice 622 W Maple St Suite B Farmington NM 87401-6590 Ph: (505) 327-4867 |
| NPI Number | 1609809235 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 2264468503 |
|---|---|
| Medicare Enrollment ID | O20050708000819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609809235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 47359 (New Mexico) | Primary |
| Provider Name | Ronald M Calcote |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386669620 PECOS PAC ID: 0345276689 Enrollment ID: I20060127000332 |
| Provider Name | Jodi K Padgett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588786537 PECOS PAC ID: 5092816678 Enrollment ID: I20070726000396 |
| Provider Name | George Lee Payne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023033461 PECOS PAC ID: 9436185774 Enrollment ID: I20100819001119 |
| Provider Name | Lance Mckay Harmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811912157 PECOS PAC ID: 1254323108 Enrollment ID: I20100819001149 |
| Provider Name | Charlene Miche Hagen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306154463 PECOS PAC ID: 2264617414 Enrollment ID: I20110503000453 |
| Provider Name | Joseph D Hakes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407000714 PECOS PAC ID: 9830360874 Enrollment ID: I20110922000413 |
| Provider Name | Aaron P Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881096642 PECOS PAC ID: 6204158363 Enrollment ID: I20141201001960 |
| Provider Name | Mark Himes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043571458 PECOS PAC ID: 2163712860 Enrollment ID: I20160609000150 |
| Provider Name | Taylor Wade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710464482 PECOS PAC ID: 9638406523 Enrollment ID: I20210622001031 |
| Provider Name | Clarissa Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356093983 PECOS PAC ID: 6901293588 Enrollment ID: I20220429000063 |
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