Organization
SAN MIGUEL CLINIC CORP
Active
Other names
LV Medical Group- Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P WRIGHT (DIRECTOR)
(615) 778-1502
Entity
Organization
Contact information
Practice address
2515 RIDGE RUNNER RD, LAS VEGAS, NM 87701-4972
(505) 425-2662
(505) 425-6410
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 778-8071
(615) 628-2288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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