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Organization

SOUTHEAST NEW MEXICO PODIATRY ASSOCIATES INC

Active
Other names
Southeast New Mexico Podiatry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LYLE REY FOLSOM DPM (OWNER PHYSICIAN)
(575) 885-3445
Entity
Organization

Contact information

Practice address
1016 W PIERCE ST, CARLSBAD, NM 88220-4013
(575) 885-3445
(575) 887-0163
Mailing address
1016 W PIERCE ST, CARLSBAD, NM 88220-4013
(575) 885-3445
(575) 887-0163

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89008863
NM
01
DA5243
RR MEDICARE
NM
Enumeration date
10/06/2006
Last updated
11/05/2010
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