| Northern Nm Medical Management, Llc | |
|
1421 Luisa Street Suite B Santa Fe NM 87505-4073 | |
| (505) 982-8338 | |
| (505) 982-8393 |
| Full Name | Northern Nm Medical Management, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1421 Luisa Street, Santa Fe, New Mexico |
| Authorized Official Name and Position | John Stanley Caskey (MEDICAL PROVIDER/OWNER) |
| Authorized Official Contact | 5059828338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Nm Medical Management, Llc 1421 Luisa Street Suite 1 Santa Fe NM 87505-4073 Ph: (505) 982-8338 | Northern Nm Medical Management, Llc 1421 Luisa Street Suite B Santa Fe NM 87505-4073 Ph: (505) 982-8338 |
| NPI Number | 1558875260 |
|---|---|
| Provider Enumeration Date | 11/17/2017 |
| Last Update Date | 11/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558875260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD2006-0456 (New Mexico) | Primary |
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