Healthcare Provider Details
I. General information
NPI: 1144166521
Provider Name (Legal Business Name): UNM MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6701 FORTUNA RD NW
ALBUQUERQUE NM
87121-1306
US
IV. Provider business mailing address
800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US
V. Phone/Fax
- Phone: 505-253-9510
- Fax:
- Phone: 505-272-1476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1000X |
| Taxonomy | Student Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JILL
C.
KLAR
Title or Position: COO
Credential: CHIEF OPER OFFICER
Phone: 505-272-3203