| New Mexico Migraine Clinic | |
|
2901 Juan Tabo Blvd Ne Ste 10 Albuquerque NM 87112-1885 | |
| (505) 926-1767 | |
| Not Available |
| Full Name | New Mexico Migraine Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 2901 Juan Tabo Blvd Ne Ste 10, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jonah Foutz (MEMBER) |
| Authorized Official Contact | 5059261767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Mexico Migraine Clinic 100 Rome Ln Corrales NM 87048-9006 Ph: (505) 926-1767 | New Mexico Migraine Clinic 2901 Juan Tabo Blvd Ne Ste 10 Albuquerque NM 87112-1885 Ph: (505) 926-1767 |
| NPI Number | 1497255400 |
|---|---|
| Provider Enumeration Date | 02/15/2018 |
| Last Update Date | 02/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497255400 | NPI | - | NPPES |
| 47989050 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DD3662 (New Mexico) | Primary |
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