# FOUR CORNERS RADIATION ONCOLOGY PC

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

## Provider details

- **NPI number:** 1720290968
- **Authorized official:** DR. LINH NGOC NGUYEN M.D. (OWNER)
- **Authorized official phone:** (505) 599-6105

## Contact information

- **Practice address:** 800 W MAPLE, FARMINGTON, NM 87401
- **Practice address phone:** (505) 599-6105
- **Mailing address:** PO BOX 1956, FARMINGTON, NM 87499
- **Mailing address phone:** (505) 334-0622
- **Mailing address fax:** (505) 334-0622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2471R0002X | Radiation Therapy Radiologic Technologist | MD2004-0204 | NM | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020