Provider Demographics
NPI:1639399967
Name:VIGIL, PATRICK NORMAN II (MT (AAB))
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:NORMAN
Last Name:VIGIL
Suffix:II
Gender:M
Credentials:MT (AAB)
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 523
Mailing Address - Street 2:
Mailing Address - City:LA LUZ
Mailing Address - State:NM
Mailing Address - Zip Code:88337-0523
Mailing Address - Country:US
Mailing Address - Phone:505-434-1780
Mailing Address - Fax:505-434-1780
Practice Address - Street 1:318 ABALONE LOOP RD
Practice Address - Street 2:
Practice Address - City:MESCALERO
Practice Address - State:NM
Practice Address - Zip Code:88340
Practice Address - Country:US
Practice Address - Phone:505-464-4441
Practice Address - Fax:505-464-4422
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist