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General NPI Number Information
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NPI Number | 1750396909
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 S LAKE ST
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City | FARMINGTON
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State | NM
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Zip | 87401-5619
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Country | US
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Telephone | 505-325-7531
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Fax | 505-326-2186
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Provider Business Mailing Address
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Address Line | 301 S LAKE ST
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City | FARMINGTON
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State | NM
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Zip | 87401-5619
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Country | US
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Telephone | 505-325-7531
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Fax | 505-326-2186
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Authorized Official
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Title or Position | DR.
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Name | DR. JAMES JOSEPH SPENCE
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Credential | M.D.
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Telephone | 505-325-7531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 78266
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License Number State | NM
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