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Contact Information

ANIMAS DERMATOLOGY MD PC
4801 N BUTLER AVE STE 9101
FARMINGTON, NM87401-3300
 Phone: 505-324-8375
 Fax: 505-327-4638
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for ANIMAS DERMATOLOGY MD PC

NPI # 1063576148
LBN Legal business name ANIMAS DERMATOLOGY MD PC
Authorized official JEAN GRAHAM - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/21/2006
Last updated 08/17/2018 - About 8 years ago
Identifiers
NM License # 97-254
NM Medicaid Q2833
NM Other NM012425 BLUE CROSS BLUE SHIELD NM
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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