Organization
FOUR CORNERS PSYCHIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES R DIGIOIA DO (PRESIDENT)
(505) 516-0252
Entity
Organization
Contact information
Practice address
3751 N BUTLER AVE, STE 115, FARMINGTON, NM 87401-6435
(505) 516-0252
(505) 516-0057
Mailing address
3751 N BUTLER AVE, STE 115, FARMINGTON, NM 87401-6435
(505) 516-0252
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A121503
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09057315
—
NM
01
—
1154312742
NPI
—
Enumeration date
01/17/2009
Last updated
01/17/2009
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