Organization
TALL PINES MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN SPENCE (OFFICE MANAGER)
(575) 257-4061
Entity
Organization
Contact information
Practice address
714 MECHEM DR, RUIDOSO, NM 88345-6905
(575) 257-4061
(575) 257-4445
Mailing address
714 MECHEM DR, RUIDOSO, NM 88345-6905
(575) 257-4061
(575) 257-4445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
88-74
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03020
—
NM
Enumeration date
08/30/2006
Last updated
02/16/2012
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