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Organization
ST. VINCENT HOSPITAL
Active
Organization
ST. VINCENT HOSPITAL
Active
Other names
Alan Rogers, MD
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA L GOMEZ (CREDENTIALING COORDINATOR)
(505) 820-5227
Entity
Organization
Contact information
Practice address
530 HARKLE RD SUITE A, SANTA FE, NM 87505-4713
(505) 983-6911
(505) 983-7212
Mailing address
455 SAINT MICHAELS DR, MEDICAL STAFF OFFICE, SANTA FE, NM 87505-7601
(505) 820-8227
(505) 820-5440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001164
LOVELACE HEALTHCARE
—
01
—
14943
MOLINA
—
05
—
45690
—
NM
01
—
NM002A08
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/23/2007
Last updated
12/27/2007
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