Healthcare Provider Details

I. General information

NPI: 1891736682
Provider Name (Legal Business Name): FAMILY PHYSICIANS OF ALBUQUERQUE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 EUBANK BLVD NE SUITE F
ALBUQUERQUE NM
87111-3575
US

IV. Provider business mailing address

3825 EUBANK BLVD NE SUITE F
ALBUQUERQUE NM
87111-3575
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-4080
  • Fax: 505-292-1839
Mailing address:
  • Phone: 505-292-4080
  • Fax: 505-292-1839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD EDWARD PICHLER
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 505-292-4080