Healthcare Provider Details

I. General information

NPI: 1285645093
Provider Name (Legal Business Name): TONI A. PRICE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TONI ARMANDA MURPHY PRICE DO, PHD

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6349 HIGHWAY 550
CUBA NM
87013
US

IV. Provider business mailing address

PO BOX 638 6349 HIGHWAY 550
CUBA NM
87013
US

V. Phone/Fax

Practice location:
  • Phone: 575-289-3291
  • Fax: 575-289-3648
Mailing address:
  • Phone: 575-289-3291
  • Fax: 575-289-3648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberA-1548-10
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: