| Southwest Family Practice, Pc | |
|
304 N. Locke Ave. Farmington Farminton NM 87401 | |
| (505) 324-1100 | |
| (505) 324-1117 |
| Full Name | Southwest Family Practice, Pc |
|---|---|
| Speciality | General Practice |
| Location | 304 N. Locke Ave., Farminton, New Mexico |
| Authorized Official Name and Position | Margaret Louise Cassidy (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 5053241100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Family Practice, Pc 304 N. Locke Ave. Farmington NM 87401 Ph: (505) 324-1100 | Southwest Family Practice, Pc 304 N. Locke Ave. Farmington Farminton NM 87401 Ph: (505) 324-1100 |
| NPI Number | 1215025390 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 09/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215025390 | NPI | - | NPPES |
| R7312 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (New Mexico) | Secondary |
| 208D00000X | General Practice | 97-202 (New Mexico) | Primary |