| |
401 Botulph Lane Santa Fe NM 87505 | |
(505) 983-8387 | |
(505) 820-2733 |
Full Name | |
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Speciality | Family Medicine |
Location | 401 Botulph Lane, Santa Fe, New Mexico |
Authorized Official Name and Position | Bruce E Gollub (PRESIDENT) |
Authorized Official Contact | 5059838387 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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401 Botulph Lane Santa Fe NM 87505 Ph: (505) 983-8387 | 401 Botulph Lane Santa Fe NM 87505 Ph: (505) 983-8387 |
NPI Number | 1255400040 |
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Provider Enumeration Date | 11/07/2006 |
Last Update Date | 07/13/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255400040 | NPI | - | NPPES |
49064 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Santa Fe Imaging Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1640 Hospital Dr, Santa Fe, NM 87505 Phone: 505-983-9350 Fax: 505-955-8763 | |
Axces Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 531 Harkle Rd Ste B, Santa Fe, NM 87505 Phone: 505-207-8078 Fax: 505-207-8082 | |
Joshua Brown Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1650 Hospital Dr Ste 200, Santa Fe, NM 87505 Phone: 505-982-4276 Fax: 505-983-7571 | |