Healthcare Provider Details

I. General information

NPI: 1013280791
Provider Name (Legal Business Name): RICHARD GRANT CURLESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2012
Last Update Date: 02/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 FOOTHILLS RD
SANTA FE NM
87505-4526
US

IV. Provider business mailing address

2117 FOOTHILLS RD
SANTA FE NM
87505-4526
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-2775
  • Fax:
Mailing address:
  • Phone: 505-988-2675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number87-40
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: