| Gallup Community Health | |
|
1105 Susan Ave Gallup NM 87301-4919 | |
| (206) 861-5767 | |
| Not Available |
| Full Name | Gallup Community Health |
|---|---|
| Speciality | Family Medicine |
| Location | 1105 Susan Ave, Gallup, New Mexico |
| Authorized Official Name and Position | Valory Wangler (CEO) |
| Authorized Official Contact | 2068615767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallup Community Health 2111 College Dr Gallup NM 87301-5600 Ph: (505) 397-5381 | Gallup Community Health 1105 Susan Ave Gallup NM 87301-4919 Ph: (206) 861-5767 |
| NPI Number | 1336807254 |
|---|---|
| Provider Enumeration Date | 12/08/2021 |
| Last Update Date | 05/24/2024 |
| Medicare PECOS PAC ID | 3375926975 |
|---|---|
| Medicare Enrollment ID | O20220815001928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336807254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gerald R Robertson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831161082 PECOS PAC ID: 7012008154 Enrollment ID: I20070803000490 |
| Provider Name | Jonathan L Leggett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831497783 PECOS PAC ID: 8527245349 Enrollment ID: I20140127000879 |
| Provider Name | Valory E Wangler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457579963 PECOS PAC ID: 8022178698 Enrollment ID: I20170918000105 |
| Provider Name | Christopher Robert Vesely Hoover |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982925673 PECOS PAC ID: 7214169036 Enrollment ID: I20180814002216 |
| Provider Name | Neil Christopher Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598170193 PECOS PAC ID: 6608157730 Enrollment ID: I20190919003286 |
| Provider Name | Michelle Dianne Dearmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952074742 PECOS PAC ID: 7618365727 Enrollment ID: I20211022000060 |
| Provider Name | Sarah M Llanque-white |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922524933 PECOS PAC ID: 0143596627 Enrollment ID: I20230522000628 |
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 | |
Hastaadi Neeznadiin Dba: Gallup Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 E Historic Highway 66, Gallup, NM 87301 Phone: 505-726-9642 Fax: 505-726-9642 | |
Western Nm Med Grp- Bh-gallup Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2025 E Aztec Ave, Gallup, NM 87301 Phone: 505-863-3828 Fax: 505-863-6612 | |
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 | |
David C. Mckenzie Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1808 E Aztec Ave Ste 6, Gallup, NM 87301 Phone: 505-863-9374 | |
Heavenly Health Fnp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 East Hill Avenue, Gallup, NM 87301 Phone: 505-722-6770 Fax: 505-722-6799 |