| Mr Blair Kent Hough, MD | |
|
1010 Spruce St, Pmg Espanola, Espanola, NM 87532-2724 | |
| (505) 367-0362 | |
| Not Available |
| Full Name | Mr Blair Kent Hough |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 35 Years |
| Location | 1010 Spruce St, Espanola, New Mexico |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467407031 | NPI | - | NPPES |
| 101364 | Other | MI | SHN HOSPITAL GLHP |
| 4250727 | Medicaid | MI | |
| 4258841 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD2016-0486 (New Mexico) | Primary |
| 208600000X | Surgery | 4301056501 (Michigan) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Presbyterian Espanola Hospital | Espanola, NM | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Presbyterian Healthcare Services | 9234041708 | 1179 |
| Entity Name | Presbyterian Healthcare Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Blair Kent Hough, MD Po Box 26666, Phs Provider Enrollment, Albuquerque, NM 87125-6666 Ph: () - | Mr Blair Kent Hough, MD 1010 Spruce St, Pmg Espanola, Espanola, NM 87532-2724 Ph: (505) 367-0362 |
Dr. Antonio Thomas Brecevich, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1010 Spruce St 3rd Floor Area 4, General Surgery, Espanola, NM 87532 Phone: 505-367-0340 Fax: 505-367-0346 | |
Marshall C Jordan, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: Espanola Multi-specialty Clinic, 1010 Spruce St, Espanola, NM 87532 Phone: 505-367-0340 Fax: 505-367-0346 |