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General NPI Number Information
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NPI Number | 1225103450
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Entity Type | Organization
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Legal Business Name | NEW MEXICO FOOT AND ANKLE INSTITUTE PC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 4343 PAN AMERICAN FWY NE STE 234
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-6834
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Country | US
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Telephone | 505-880-1000
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Fax | 505-880-1002
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Provider Business Mailing Address
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Address Line | 4343 PAN AMERICAN FWY NE STE 234
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-6834
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Country | US
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Telephone | 505-880-1000
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Fax | 505-880-1002
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN D IVEY
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Credential |
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Telephone | 505-880-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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