Healthcare Provider Details

I. General information

NPI: 1447264312
Provider Name (Legal Business Name): MARIA FE F HATOL MD AND ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S 8TH ST
DEMING NM
88030-4008
US

IV. Provider business mailing address

1000 S 8TH ST
DEMING NM
88030-4008
US

V. Phone/Fax

Practice location:
  • Phone: 575-544-4975
  • Fax: 575-544-4785
Mailing address:
  • Phone: 575-544-4975
  • Fax: 575-544-4785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9354
License Number StateNM

VIII. Authorized Official

Name: MR. ANKY FRILLES
Title or Position: OFFICE MANAGER
Credential:
Phone: 575-544-4975