Organization
NEW MEXICO EMERGENCY PHYSICIANS GROUP MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS G DOUGLASS (CEO)
(361) 729-0646
Entity
Organization
Contact information
Practice address
1901 RED ROCK DR, GALLUP, NM 87301-5683
(505) 863-7000
Mailing address
4932 SUNBEAM RD, JACKSONVILLE, FL 32257-6128
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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