Organization
FAMILY PRACTICE ASSOCIATES OF RATON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI J SEGOTTA (OFFICE MANAGER)
(505) 445-3626
Entity
Organization
Contact information
Practice address
411 S 3RD ST, RATON, NM 87740-4005
(505) 445-3626
(505) 445-8649
Mailing address
411 S 3RD ST, RATON, NM 87740-4005
(505) 445-3626
(505) 445-8649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02871769
—
CO
05
—
45727
—
NM
01
—
NM007097
BLUE CROSS BLUE SHEILD
NM
Enumeration date
06/04/2006
Last updated
08/22/2008
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