| Nm Small Town Family Practice, Llc | |
|
4225 Montgomery Blvd Ne Albuquerque NM 87109-1103 | |
| (505) 366-3635 | |
| (505) 392-3878 |
| Full Name | Nm Small Town Family Practice, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4225 Montgomery Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Deanna R Clark (OWNER/PROVIDER) |
| Authorized Official Contact | 5053663635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nm Small Town Family Practice, Llc 2000 Lam Ct Ne Rio Rancho NM 87144-7775 Ph: (575) 621-3940 | Nm Small Town Family Practice, Llc 4225 Montgomery Blvd Ne Albuquerque NM 87109-1103 Ph: (505) 366-3635 |
| NPI Number | 1528714870 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 02/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528714870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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