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Contact Information

CARMELITA AGODON, MD
1901 REDROCK DR
REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES
GALLUP, NM87301-5683
 Phone: 505-863-7120
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for CARMELITA AGODON · (Female)

NPI # 1710965272
Status Active
Credentials MD
Entity Individual
Enumeration date 01/05/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 2001-01
  • NM Medicaid 48126705
  • Other 85031326887301A159 CHAMPUS
  • Other P00200853 RAILROAD MEDICARE
  • Other P00211389 RAILROAD MEDICARE
  • AZ Other 768781 AHCCCS
  • NM Other NM009E83 BC/BS
  • NM Other 10004799 LOVELACE HEALTH/SALUD
  • NM Other PROVP11034 MOLINA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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