Tatum Medical Clinic | |
310 N Main Tatum NM 88267-9802 | |
(575) 398-2111 | |
(575) 398-6112 |
Full Name | Tatum Medical Clinic |
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Speciality | Clinic/Center |
Location | 310 N Main, Tatum, New Mexico |
Authorized Official Name and Position | David B Shaw (CEO/ADMINISTRATION) |
Authorized Official Contact | 5753966611 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tatum Medical Clinic 1600 North Main Lovington NM 88260-2813 Ph: (575) 396-6611 | Tatum Medical Clinic 310 N Main Tatum NM 88267-9802 Ph: (575) 398-2111 |
NPI Number | 1174559082 |
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Provider Enumeration Date | 06/23/2006 |
Last Update Date | 05/01/2014 |
Medicare PECOS PAC ID | 2466364534 |
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Medicare Enrollment ID | O20100702000113 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174559082 | NPI | - | NPPES |
45260 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 6260 (New Mexico) | Secondary |
261QR1300X | Clinic/center - Rural Health | 6260 (New Mexico) | Primary |