Organization
FEP WEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN FEDKO (CEO)
(847) 571-2467
Entity
Organization
Contact information
Practice address
1901 RED ROCK DR, GALLUP, NM 87301-5683
(505) 863-7000
Mailing address
22029 N 51ST ST, PHOENIX, AZ 85054-7143
(605) 759-7785
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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