| Schreiber Family Medicine Llc | |
|
630 Paseo Del Pueblo Sur Ste. 125 Taos NM 87571-6070 | |
| (575) 751-7430 | |
| Not Available |
| Full Name | Schreiber Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 630 Paseo Del Pueblo Sur, Taos, New Mexico |
| Authorized Official Name and Position | Lucas Edward Schreiber (OWNER) |
| Authorized Official Contact | 5757517430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Schreiber Family Medicine Llc 630 Paseo Del Pueblo Sur Ste. 125 Taos NM 87571-6070 Ph: (575) 751-7430 | Schreiber Family Medicine Llc 630 Paseo Del Pueblo Sur Ste. 125 Taos NM 87571-6070 Ph: (575) 751-7430 |
| NPI Number | 1780127712 |
|---|---|
| Provider Enumeration Date | 11/22/2016 |
| Last Update Date | 02/02/2017 |
| Medicare PECOS PAC ID | 9436431038 |
|---|---|
| Medicare Enrollment ID | O20170113002291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780127712 | NPI | - | NPPES |
| 341335302 | Other | NM | MEDICARE PTAN |
| 44583338 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2003-0355 (New Mexico) | Primary |
| Provider Name | Lucas E Schreiber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821056920 PECOS PAC ID: 5799681680 Enrollment ID: I20031210001169 |
| Provider Name | Jeremy T Edmonds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932116472 PECOS PAC ID: 6002856192 Enrollment ID: I20050813000271 |
| Provider Name | Bertrand V Bassett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578564381 PECOS PAC ID: 5193799112 Enrollment ID: I20060313000079 |
| Provider Name | Ryan Murphy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912168691 PECOS PAC ID: 2567695406 Enrollment ID: I20140430001772 |
| Provider Name | John J White |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679550362 PECOS PAC ID: 3779488705 Enrollment ID: I20190523001691 |
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