# RIO GRANDE FOOT & ANKLE SPECIALISTS LLC

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

## Provider details

- **NPI number:** 1750938478
- **Authorized official:** SUSAN MARIE TAYLOR (DIRECTOR OF OPERATIONS & CREDENTIAL)
- **Authorized official phone:** (801) 505-0821

## Contact information

- **Practice address:** 1399 WEIMER RD STE 400, TAOS, NM 87571-6348
- **Practice address phone:** (575) 214-8521
- **Practice address fax:** (877) 540-1253
- **Mailing address:** 280 S MAIN ST, BOUNTIFUL, UT 84010-6236
- **Mailing address phone:** (801) 505-0821
- **Mailing address fax:** (801) 505-0803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 08/19/2019
- **Last updated:** 12/06/2024