MEDICARE: FAMILY PHYSICIANS OF ALBUQUERQUE, PC

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	173000000X	Legal Medicine

General Provider Information

NPI Number	:	1891736682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PHYSICIANS OF ALBUQUERQUE, PC

Provider Business Mailing Address
First Line	:	3825 EUBANK BLVD NE
Second Line	:	SUITE F
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3575
Country	:	US
Telephone Number	:	505-292-4080
Fax Number	:	505-292-1839

Provider Business Practice Location Address
First Line	:	3825 EUBANK BLVD NE
Second Line	:	SUITE F
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3575
Country	:	US
Telephone Number	:	505-292-4080
Fax Number	:	505-292-1839

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. DONALD EDWARD PICHLER
Credential	:	M.D.
Telephone Number	:	505-292-4080

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	04/25/2012

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