Healthcare Provider Details

I. General information

NPI: 1578839163
Provider Name (Legal Business Name): IPC HOSPITALISTS OF NEW MEXICO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8208 LOUISIANA BLVD NE STE. C
ALBUQUERQUE NM
87113-1757
US

IV. Provider business mailing address

8208 LOUISIANA BLVD NE STE. C
ALBUQUERQUE NM
87113-1757
US

V. Phone/Fax

Practice location:
  • Phone: 602-789-0344
  • Fax: 602-870-7566
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. R. JEFFREY TAYLOR
Title or Position: PRESIDENT & COO
Credential:
Phone: 818-766-3502