| Kingsley Clinic Of New Mexico, Llc | |
|
6300 Riverside Plaza Ln Nw Ste 100 Albuquerque NM 87120-1908 | |
| (505) 405-3617 | |
| (505) 370-2053 |
| Full Name | Kingsley Clinic Of New Mexico, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6300 Riverside Plaza Ln Nw Ste 100, Albuquerque, New Mexico |
| Authorized Official Name and Position | James Kingsley (OWNER) |
| Authorized Official Contact | 5054053617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingsley Clinic Of New Mexico, Llc 6300 Riverside Plaza Ln Nw Ste 100 Albuquerque NM 87120-1908 Ph: (505) 405-3617 | Kingsley Clinic Of New Mexico, Llc 6300 Riverside Plaza Ln Nw Ste 100 Albuquerque NM 87120-1908 Ph: (505) 405-3617 |
| NPI Number | 1316545882 |
|---|---|
| Provider Enumeration Date | 10/15/2020 |
| Last Update Date | 10/15/2020 |
| Medicare PECOS PAC ID | 9739597436 |
|---|---|
| Medicare Enrollment ID | O20210419001136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316545882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | James Ralph Kingsley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841687142 PECOS PAC ID: 8325316326 Enrollment ID: I20210419001264 |
| Provider Name | Danial A Soleja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770970451 PECOS PAC ID: 6002163631 Enrollment ID: I20210624000448 |
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