Individual
CARLETTA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
407 S SCHWARTZ AVE STE 101, FARMINGTON, NM 87401-5925
(505) 609-6595
(505) 599-4633
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2003-0603
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10309713
—
NM
Enumeration date
07/13/2006
Last updated
11/08/2024
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