Provider Demographics
NPI:1578839163
Name:IPC HOSPITALISTS OF NEW MEXICO, INC
Entity Type:Organization
Organization Name:IPC HOSPITALISTS OF NEW MEXICO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:R. JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-766-3502
Mailing Address - Street 1:8208 LOUISIANA BLVD NE
Mailing Address - Street 2:STE. C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1757
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8208 LOUISIANA BLVD NE
Practice Address - Street 2:STE. C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1757
Practice Address - Country:US
Practice Address - Phone:602-789-0344
Practice Address - Fax:602-870-7566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM27573371Medicaid
NM889234086OtherBCBS
NMNMA102083Medicare PIN