| Corrales Family Practice Llc | |
|
3841 Corrales Rd Corrales NM 87048-9311 | |
| (505) 792-3065 | |
| (505) 792-4004 |
| Full Name | Corrales Family Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3841 Corrales Rd, Corrales, New Mexico |
| Authorized Official Name and Position | Alyson P Thal (OWNER) |
| Authorized Official Contact | 5057923065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corrales Family Practice Llc 3841 Corrales Rd Corrales NM 87048-9311 Ph: (505) 792-3065 | Corrales Family Practice Llc 3841 Corrales Rd Corrales NM 87048-9311 Ph: (505) 792-3065 |
| NPI Number | 1043401508 |
|---|---|
| Provider Enumeration Date | 08/08/2007 |
| Last Update Date | 06/12/2008 |
| Medicare PECOS PAC ID | 7618005588 |
|---|---|
| Medicare Enrollment ID | O20100513000686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043401508 | NPI | - | NPPES |
| 34224801 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 86346 (New Mexico) | Primary |
| Provider Name | Alyson P Thal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316050560 PECOS PAC ID: 8527196492 Enrollment ID: I20100513000722 |
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William Fitzpatrick, Md, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Coyote Trl, Corrales, NM 87048 Phone: 505-792-3063 Fax: 505-922-6405 | |
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