Organization
WILBUR A TSO MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILBUR TSO MD (PRESIDENT)
(505) 327-9876
Entity
Organization
Contact information
Practice address
211 N AUBURN AVE, FARMINGTON, NM 87401-8411
(505) 327-9876
(505) 326-6650
Mailing address
211 N AUBURN AVE, FARMINGTON, NM 87401-8411
(505) 327-9876
(505) 326-6650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81-330
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09811
—
NM
01
—
600522369
MEDICARE PTAN
NM
Enumeration date
03/26/2007
Last updated
07/20/2011
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