| Tom Wulf Md Llc | |
|
607 W Country Club Rd Roswell NM 88201-5211 | |
| (575) 208-7795 | |
| (575) 208-7785 |
| Full Name | Tom Wulf Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 607 W Country Club Rd, Roswell, New Mexico |
| Authorized Official Name and Position | Thomas Wulf (OWNER) |
| Authorized Official Contact | 5752087795 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tom Wulf Md Llc 313 W Country Club Rd Ste 15 Roswell NM 88201-5804 Ph: (575) 208-7795 | Tom Wulf Md Llc 607 W Country Club Rd Roswell NM 88201-5211 Ph: (575) 208-7795 |
| NPI Number | 1407488182 |
|---|---|
| Provider Enumeration Date | 02/10/2020 |
| Last Update Date | 05/11/2020 |
| Medicare PECOS PAC ID | 8820410301 |
|---|---|
| Medicare Enrollment ID | O20200630001277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407488182 | NPI | - | NPPES |
| 42637716 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 251G00000X | Hospice Care, Community Based | (* (Not Available)) | Secondary |
| Provider Name | Thomas Wulf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467405779 PECOS PAC ID: 1456354661 Enrollment ID: I20060808000437 |
| Provider Name | Jane-frances Shiti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215461629 PECOS PAC ID: 9638415078 Enrollment ID: I20191010002673 |
| Provider Name | Akira Kobayashi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821483751 PECOS PAC ID: 4082922570 Enrollment ID: I20201105000511 |
Donald J Willis D.o. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 313 W Country Club Rd, Suite 9, Roswell, NM 88201 Phone: 575-624-2095 Fax: 575-627-5721 | |
Southern New Mexico Medical Association, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 W. Country Club Rd, Roswell, NM 88201 Phone: 505-623-1442 Fax: 505-623-3835 | |
App Of New Mexico Hm Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 575-622-8170 Fax: 629-216-0568 | |
Roswell Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 712 W Hobbs St, Roswell, NM 88203 Phone: 575-623-5263 | |
Roswell Osteopathic Medical Clinic, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 W. Hobbs St., Roswell, NM 88203 Phone: 575-623-3311 Fax: 575-622-1273 | |
Lovelace Health System, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1627 S Union Ave, Roswell, NM 88203 Phone: 575-208-0106 | |
Eye Catchers Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 E College Blvd, Roswell, NM 88201 Phone: 575-625-9800 Fax: 575-624-1724 |