MEDICARE: ISABEL C. VIGIL, MD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659304681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISABEL C. VIGIL, MD, PC

Provider Business Mailing Address
First Line	:	2803 DORAL CT
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8616
Country	:	US
Telephone Number	:	505-522-1628
Fax Number	:	505-522-1636

Provider Business Practice Location Address
First Line	:	2803 DORAL CT
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8616
Country	:	US
Telephone Number	:	505-522-1628
Fax Number	:	505-522-1636

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ISABEL C VIGIL
Credential	:	MD
Telephone Number	:	505-522-1628

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	06/02/2008

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