Provider Demographics
NPI:1750396909
Name:INTERNAL MEDICINE ASSOCIATES, P.C.
Entity type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-325-7531
Mailing Address - Street 1:301 S LAKE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5619
Mailing Address - Country:US
Mailing Address - Phone:505-325-7531
Mailing Address - Fax:505-326-2186
Practice Address - Street 1:301 S LAKE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5619
Practice Address - Country:US
Practice Address - Phone:505-325-7531
Practice Address - Fax:505-326-2186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM78266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM18499Medicaid
NMD35978Medicare UPIN