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Organization

BLUE SKIES PRIMARY CARE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT GRAOR M.D. (PRESIDENT)
(505) 546-4811
Entity
Organization

Contact information

Practice address
1110 W FLORIDA ST, DEMING, NM 88030-4908
(505) 546-4811
(505) 546-4821
Mailing address
1110 W FLORIDA ST, DEMING, NM 88030-4908
(505) 546-4811
(505) 546-4821

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
70974764
NM
Enumeration date
02/08/2007
Last updated
01/28/2010
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