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Organization

PRESBYTERIAN MEDICAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUG SMITH (VP OF FINANCE)
(505) 982-5565
Entity
Organization

Contact information

Practice address
1422 PASEO DE PERALTA, SANTA FE, NM 87501-4391
(505) 820-3466
(505) 992-4990
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
(505) 820-3466
(505) 992-4990

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
103T00000X
Psychologist
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
1223G0001X
General Practice Dentistry
207Q00000X
Family Medicine Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2371519
MEDICARE OSCAR/CERTIFICATION
NM
Enumeration date
05/19/2006
Last updated
01/14/2021
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