Healthcare Provider Details

I. General information

NPI: 1083635106
Provider Name (Legal Business Name): CLAUDE D GELINAS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 JEFFERSON ST NE SUITE 350
ALBUQUERQUE NM
87109-4379
US

IV. Provider business mailing address

6801 JEFFERSON ST NE SUITE 350
ALBUQUERQUE NM
87109-4379
US

V. Phone/Fax

Practice location:
  • Phone: 505-242-1711
  • Fax: 505-242-0291
Mailing address:
  • Phone: 505-242-1711
  • Fax: 505-242-0189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number97245
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number97245
License Number StateNM

VIII. Authorized Official

Name: CANDRA THOMPSON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 505-242-1711