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General NPI Number Information
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NPI Number | 1033527015
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Entity Type | Organization
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Legal Business Name | ROBBEN R. GINGERY, MD, LLC
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 3188 SOUTHERN BLVD SE SUITE B1
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City | RIO RANCHO
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State | NM
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Zip | 87124-1990
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Country | US
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Telephone | 505-200-9158
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Fax | 505-200-9497
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Provider Business Mailing Address
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Address Line | 3188 SOUTHERN BLVD SE SUITE B1
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City | RIO RANCHO
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State | NM
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Zip | 87124-1990
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Country | US
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Telephone | 505-200-9158
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Fax | 505-200-9497
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBBEN R GINGERY
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Credential | MD LLC
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Telephone | 505-200-9158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 91-207
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License Number State | NM
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