Organization
RIO GRANDE INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN J GOODLUCK MD (PRESIDENT)
(505) 792-2636
Entity
Organization
Contact information
Practice address
4801 MCMAHON BLVD NW, SUITE 235, ALBUQUERQUE, NM 87114-5090
(505) 792-2636
(505) 234-1707
Mailing address
4801 MCMAHON BLVD NW, SUITE 235, ALBUQUERQUE, NM 87114-5090
(505) 792-2636
(505) 234-1707
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
97251
NM
Other
Enumeration date
02/22/2011
Last updated
10/19/2011
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