| Tall Pines Medical Inc | |
|
714 Mechem Dr Ruidoso NM 88345-6905 | |
| (575) 257-4061 | |
| (575) 257-4445 |
| Full Name | Tall Pines Medical Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 714 Mechem Dr, Ruidoso, New Mexico |
| Authorized Official Name and Position | Ann Spence (OFFICE MANAGER) |
| Authorized Official Contact | 5752574061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tall Pines Medical Inc 714 Mechem Dr Ruidoso NM 88345-6905 Ph: (575) 257-4061 | Tall Pines Medical Inc 714 Mechem Dr Ruidoso NM 88345-6905 Ph: (575) 257-4061 |
| NPI Number | 1750490017 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 02/16/2012 |
| Medicare PECOS PAC ID | 5890743504 |
|---|---|
| Medicare Enrollment ID | O20050110000769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750490017 | NPI | - | NPPES |
| 03020 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 88-74 (New Mexico) | Primary |
| Provider Name | Michael D Spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992706352 PECOS PAC ID: 0345298063 Enrollment ID: I20050110000910 |
| Provider Name | Ann Renee Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467430454 PECOS PAC ID: 3375452402 Enrollment ID: I20150115001731 |
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