# UNIVERSITY OF NEW MEXICO MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043661010
- **Authorized official:** MS. KATHERINE A LAFOND (COORDINATOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (505) 272-8950

## Contact information

- **Practice address:** 933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
- **Practice address phone:** (505) 272-8950
- **Practice address fax:** (505) 272-6276
- **Mailing address:** 933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
- **Mailing address phone:** (505) 272-8950
- **Mailing address fax:** (505) 272-6276

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/30/2016
- **Last updated:** 06/30/2016