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NPI Code Detail

MEDICARE: HIGH PLAINS MEDICAL, INC.

MEDICARE: HIGH PLAINS MEDICAL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1528074390
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGH PLAINS MEDICAL, INC.
Provider Business Mailing Address
First Line : 12127B HWY 14 N STE 5
Second Line :
City : CEDAR CREST
State : NM
Zip : 87008-9499
Country : US
Telephone Number : 505-281-5180
Fax Number : 505-832-5024
Provider Business Practice Location Address
First Line : 1108 W US ROUTE 66
Second Line :
City : MORIARTY
State : NM
Zip : 87035-1006
Country : US
Telephone Number : 505-832-4434
Fax Number : 505-832-5024
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. VICTORIA LYNN GALLEGOS
Credential :
Telephone Number : 505-832-4434
Provider Enumeration Date : 07/31/2006
Last Update Date : 05/20/2016

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Directions to “HIGH PLAINS MEDICAL, INC. ” Practice Location

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