John R. Vigil, Md, Llc | |
3900 Eubank Blvd Ne Ste 18 Albuquerque NM 87111-3427 | |
(505) 884-3344 | |
Not Available |
Full Name | John R. Vigil, Md, Llc |
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Speciality | General Practice |
Location | 3900 Eubank Blvd Ne Ste 18, Albuquerque, New Mexico |
Authorized Official Name and Position | Johnnie R Vigil (OWNER/MD) |
Authorized Official Contact | 5052631422 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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John R. Vigil, Md, Llc 205 W Boutz Rd Bldg 1 Las Cruces NM 88005-3259 Ph: (575) 532-7000 | John R. Vigil, Md, Llc 3900 Eubank Blvd Ne Ste 18 Albuquerque NM 87111-3427 Ph: (505) 884-3344 |
NPI Number | 1992084008 |
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Provider Enumeration Date | 08/06/2011 |
Last Update Date | 10/05/2021 |
Medicare PECOS PAC ID | 9830330174 |
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Medicare Enrollment ID | O20130729000607 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992084008 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 89-319 (New Mexico) | Primary |
Provider Name | Johnnie R Vigil |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1285762377 PECOS PAC ID: 2466351051 Enrollment ID: I20040102000408 |
Provider Name | Paul E Romo |
---|---|
Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1306089313 PECOS PAC ID: 2062649007 Enrollment ID: I20141014000472 |
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