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FOUR CORNERS PAIN MANAGEMENT LLC NPI 1720317365


NPI Information

NPI: 1720317365
Provider Name: FOUR CORNERS PAIN MANAGEMENT LLC

Doing Business As: FOUR CORNERS SPINE AND PAIN

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
2500 FARMINGTON AVE
FARMINGTON, NM
ZIP 87401
Phone: (505) 326-7246
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FOUR CORNERS PAIN MANAGEMENT LLC is a specialist in Farmington, NM. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. FOUR CORNERS PAIN MANAGEMENT LLC NPI is 1720317365. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Four Corners Spine And Pain.

The provider's business location address is:

2500 FARMINGTON AVE
FARMINGTON, NM
ZIP 87401
Phone: (505) 326-7246
Fax: (505) 592-0063

The provider's authorized official is Danielle W Orozco .
The authorized official title is Clinic Manager and has the following contact phone number (505) 326-7246.

The enumeration date for this NPI number is 12/10/2009 and was last updated on 8/22/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DR0371OTHERNEW MEXICOR R MEDICARE
2484941MEDICAIDARIZONA
388586251MEDICAIDNEW MEXICO
461029262MEDICAIDCOLORADO
51720317365MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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