Healthcare Provider Details

I. General information

NPI: 1609868066
Provider Name (Legal Business Name): MATTHEW SCOTT MCGLOTHLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 RIO RANCHO BLVD SE
RIO RANCHO NM
87124-1570
US

IV. Provider business mailing address

303 ROMA AVE NW FL 7
ALBUQUERQUE NM
87102-2251
US

V. Phone/Fax

Practice location:
  • Phone: 505-896-8610
  • Fax: 505-896-8618
Mailing address:
  • Phone: 210-885-8550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2025-1234
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM1920
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: