Healthcare Provider Details

I. General information

NPI: 1871608703
Provider Name (Legal Business Name): WILLIAM MCCONNELL MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 JEFFERSON ST NE
ALBUQUERQUE NM
87109-4313
US

IV. Provider business mailing address

1725 RITA DR NE
ALBUQUERQUE NM
87106-1129
US

V. Phone/Fax

Practice location:
  • Phone: 505-344-9478
  • Fax:
Mailing address:
  • Phone: 505-268-1883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number85-244
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number85-244
License Number StateNM

VIII. Authorized Official

Name: NANCY E BAIRD
Title or Position: MANAGER
Credential:
Phone: 505-771-9084