Provider Demographics
NPI:1881679777
Name:GILA OB GYN ASSOCIATES PC
Entity Type:Organization
Organization Name:GILA OB GYN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STEINZIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-538-2936
Mailing Address - Street 1:3201 RIDGELOOP
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061
Mailing Address - Country:US
Mailing Address - Phone:505-538-2936
Mailing Address - Fax:505-538-2775
Practice Address - Street 1:3201 RIDGELOOP
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061
Practice Address - Country:US
Practice Address - Phone:505-538-2936
Practice Address - Fax:505-538-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM70205207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM26740Medicaid
NM26740Medicaid
D35986Medicare UPIN