Healthcare Provider Details

I. General information

NPI: 1427094101
Provider Name (Legal Business Name): DEBBIE A. VIGIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 12/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1692 HOSPITAL DR
SANTA FE NM
87505-4754
US

IV. Provider business mailing address

1692 HOSPITAL DR
SANTA FE NM
87505-4754
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-8601
  • Fax:
Mailing address:
  • Phone: 505-983-8601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number87-199
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: