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General NPI Number Information
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NPI Number | 1780697300
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Entity Type | Individual
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Provider Name | LINDA MARIE STOGNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | ESPERANZA FAMILY HEALTH CENTER 903 C FIFTH ST
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City | ESTANCIA
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State | NM
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Zip | 87016
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Country | US
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Telephone | 505-384-2777
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Fax | 505-384-2204
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Provider Business Mailing Address
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Address Line | PO BOX 158 701 ALLEN
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City | ESTANCIA
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State | NM
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Zip | 87016-0158
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Country | US
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Telephone | 505-384-5068
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Fax | 505-384-2204
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 86-377
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License Number State | NM
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