| Rk Illango, Md, Inc | |
|
719 W Apache St Farmington NM 87401-5512 | |
| (614) 309-1265 | |
| Not Available |
| Full Name | Rk Illango, Md, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 719 W Apache St, Farmington, New Mexico |
| Authorized Official Name and Position | Ramanathan K Illango (OWNER) |
| Authorized Official Contact | 6143091265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rk Illango, Md, Inc 719 W Apache St Farmington NM 87401-5512 Ph: (614) 309-1265 | Rk Illango, Md, Inc 719 W Apache St Farmington NM 87401-5512 Ph: (614) 309-1265 |
| NPI Number | 1497268015 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497268015 | NPI | - | NPPES |
| XX | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD2013-0749 (New Mexico) | Primary |
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