Organization
K & L ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH DALE SLACK MD. (PRESIDENT)
(505) 327-2206
Entity
Organization
Contact information
Practice address
656 W MAPLE ST, FARMINGTON, NM 87401-5968
(505) 327-2206
(505) 325-4969
Mailing address
656 W MAPLE STREET, FARMINGTON, NM 87401
(505) 327-2206
(505) 325-4969
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MD2003-0686
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41035259
—
NM
Enumeration date
07/31/2006
Last updated
08/22/2020
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