| Genesis Physician Associates Llc | |
|
4801 N Butler Avenue Suite 8102 Farmington NM 87401-0818 | |
| (505) 436-2671 | |
| Not Available |
| Full Name | Genesis Physician Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4801 N Butler Avenue, Farmington, New Mexico |
| Authorized Official Name and Position | Uche Obisike (PRESIDENT) |
| Authorized Official Contact | 5054362671 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Physician Associates Llc 4801 N Butler Avenue Suite 8102 Farmington NM 87401-0818 Ph: (505) 436-2671 | Genesis Physician Associates Llc 4801 N Butler Avenue Suite 8102 Farmington NM 87401-0818 Ph: (505) 436-2671 |
| NPI Number | 1740569763 |
|---|---|
| Provider Enumeration Date | 08/08/2011 |
| Last Update Date | 10/29/2020 |
| Medicare PECOS PAC ID | 1456525021 |
|---|---|
| Medicare Enrollment ID | O20111116000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740569763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD2006-0141 (New Mexico) | Primary |
| Provider Name | Uche N Obisike |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265465884 PECOS PAC ID: 9739182148 Enrollment ID: I20061011000715 |
| Provider Name | Clarissa Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124724646 PECOS PAC ID: 7810361201 Enrollment ID: I20230327001602 |
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