NPI 1114920717

San Miguel Clinic Corp

Organisation Family Medicine Physician Las Vegas, NM

Practice location

Address: 108 Legion Dr STE a, Las Vegas, NM 87701-4898
Phone: (505) 454-9499
Mailing address: PO Box 5009, Brentwood, TN 37024-5009

Authorised official

Name: Laura J Fey
Title: Director Revenue Cycle
Phone: (615) 221-3641

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in New Mexico →

Registry record

NPI: 1114920717
Entity type: Organization
NPI issued: 27 May 2005
Record last updated: 17 Oct 2023

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.