| Taddy Family Clinic | |
|
615 W Mermod St Carlsbad NM 88220-4912 | |
| (575) 885-7714 | |
| (575) 885-7714 |
| Full Name | Taddy Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 615 W Mermod St, Carlsbad, New Mexico |
| Authorized Official Name and Position | Nii Tetteh Tsuru Addy (PRESIDENT) |
| Authorized Official Contact | 9894821002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Taddy Family Clinic 615 W Mermod St Carlsbad NM 88220-3513 Ph: (575) 885-7714 | Taddy Family Clinic 615 W Mermod St Carlsbad NM 88220-4912 Ph: (575) 885-7714 |
| NPI Number | 1043541626 |
|---|---|
| Provider Enumeration Date | 01/21/2010 |
| Last Update Date | 09/14/2016 |
| Medicare PECOS PAC ID | 7911030580 |
|---|---|
| Medicare Enrollment ID | O20100803000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043541626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A-1299-05 (New Mexico) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | A-1299-05 (New Mexico) | Secondary |
| Provider Name | Nii Tetteh Tsuru Addy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790855732 PECOS PAC ID: 3971554593 Enrollment ID: I20050401000270 |
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