Organization
MIMBRES HEALTH MAINTENANCE ASSOCIATES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE LAFON MD (MEDICAL DIRECTOR)
(505) 544-2800
Entity
Organization
Contact information
Practice address
850 W FLORIDA ST, DEMING, NM 88030-4558
(505) 544-2800
(505) 544-2801
Mailing address
850 W. FLORIDA, DEMING, NM 88030
(505) 544-2800
(505) 544-2801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81-71
NM
2080N0001X
Neonatal-Perinatal Medicine Physician
2003-0634
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26393
—
NM
05
—
47426781
—
NM
05
—
48702
—
NM
Enumeration date
07/31/2006
Last updated
08/27/2010
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