NPI 1336348135

Aztec Family Practice PA

Organisation Exclusive Provider Organization Aztec, NM

Practice location

Address: 406 S Park Ave, Aztec, NM 87410-2226
Phone: (505) 334-2852

Authorised official

Name: Bryan Poe
Title: Owner
Phone: (505) 334-2852

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence A-834-86 (NM)

Other Exclusive Provider Organization providers in New Mexico →

Registry record

NPI: 1336348135
Entity type: Organization
NPI issued: 12 Jul 2007
Record last updated: 20 May 2008

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.