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Organization

EYE ASSOCIATES OF NEW MEXICO LTD

Active
Other names
Eye Associates of New Mexico
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE ROLANDE BUTCHER (CREDENTIALING ADMINISTRATOR)
(505) 828-4923
Entity
Organization

Contact information

Practice address
806 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3657
(505) 842-6575
(505) 213-0103
Mailing address
8801 HORIZON BLVD NE, SUITE 360, ALBUQUERQUE, NM 87113-1533
(505) 828-4923
(505) 213-0103

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1198269-02
TX
05
310132
AZ
05
47951
NM
05
94-000619
CO
01
CH4370
RAILROAD MEDICARE
NM
01
CN6728
RAILROAD MEDICARE
NM
05
K5006
NM
Enumeration date
06/11/2006
Last updated
03/13/2017
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