Organization
SANTA FE FOOT AND ANKLE INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA L KING DPM (MEMBER/OWNER)
(505) 988-3338
Entity
Organization
Contact information
Practice address
2019 GALISTEO ST, UNIT A4, SANTA FE, NM 87505-2143
(505) 988-3338
(505) 982-3668
Mailing address
2019 GALISTEO ST, UNIT A4, SANTA FE, NM 87505-2143
(505) 988-3338
(505) 982-3668
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01331752
AMERIGROUP
NM
01
—
1730266032
IND NPI
NM
01
—
4781043
CIGNA
NM
05
—
85207578
—
NM
01
—
9558062
AETNA
NM
01
—
DR8662
RR MCARE GROUP PIN
NM
01
—
NM296
NM LICENSE
NM
Enumeration date
11/03/2009
Last updated
06/14/2015
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