Provider Demographics
NPI:1235300419
Name:PHILIP F. BARTEL, PA
Entity Type:Organization
Organization Name:PHILIP F. BARTEL, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:BARTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, PA
Authorized Official - Phone:505-881-9764
Mailing Address - Street 1:7520 MONTGOMERY BLVD NE
Mailing Address - Street 2:BLDG D12
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1534
Mailing Address - Country:US
Mailing Address - Phone:505-881-9764
Mailing Address - Fax:505-881-9774
Practice Address - Street 1:7520 MONTGOMERY BLVD NE
Practice Address - Street 2:BLDG D12
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1534
Practice Address - Country:US
Practice Address - Phone:505-881-9764
Practice Address - Fax:505-881-9774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM249332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1293070001Medicare NSC