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Organization

SANDIA OBGYN ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARL JOHN CONNORS D.O. (PRESIDENT)
(505) 727-3280
Entity
Organization

Contact information

Practice address
4705 MONTGOMERY BLVD NE, SUITE 105, ALBUQUERQUE, NM 87109-1226
(505) 727-3280
(505) 727-3282
Mailing address
4705 MONTGOMERY BLVD NE, SUITE 105, ALBUQUERQUE, NM 87109-1226
(505) 727-3280
(505) 727-3282

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
A913-90
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201001970
MOLINA HEALTHCARE
NM
05
F8452
NM
01
NM004926
BCBS -HMO OF NEW MEXICO
NM
Enumeration date
05/16/2007
Last updated
09/18/2008
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