MEDICARE: THE FAMILY CLINIC

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
1	207Q00000X	Family Medicine Physician	97374	NM

General Provider Information

NPI Number	:	1851374433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FAMILY CLINIC

Provider Business Mailing Address
First Line	:	1280 E 32ND ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7229
Country	:	US
Telephone Number	:	505-388-1242
Fax Number	:	505-534-1859

Provider Business Practice Location Address
First Line	:	1280 E 32ND ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7229
Country	:	US
Telephone Number	:	505-388-1242
Fax Number	:	505-534-1859

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHARLOTTE MCGAUGHEY
Credential	:
Telephone Number	:	505-388-1242

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	08/22/2020

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Directions to “THE FAMILY CLINIC ” Practice Location

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