NPI 1053672485

Angel Fire Primary Care

Organisation General Practice Physician Red River, NM

Practice location

Address: 200 a Pioneer Road, Red River, NM 87558-0000
Phone: (575) 754-1773
Fax: (505) 989-3536
Mailing address: 707 Paseo de Peralta, Santa Fe, NM 87501-1922

Authorised official

Name: Lesa D Fraker
Title: President
Phone: (505) 989-8707

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in New Mexico →

Registry record

NPI: 1053672485
Entity type: Organization
NPI issued: 1 Jun 2012
Record last updated: 1 Jun 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.