Blue and Red Bird Corporation, PC.
Organization Active NPI Primary Care Clinic/Center · Clovis, NM
NPI 1124579958 · NPPES record last updated Oct 17, 2016
Key facts
- NPI
- 1124579958
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 81202 (NM)
- Legal business name
- BLUE AND RED BIRD CORPORATION, PC.
- Practice address
- 815 W 14TH St
Clovis, NM 88101-5514 - Phone
- (575) 762-6492
- Fax
- (757) 935-8333
- NPI assigned
- Oct 17, 2016
- Organization subpart
- No
Authorized official
- Name
- Ali M Ghaffari Sr., M.D
- Title
- President
- Phone
- (575) 762-6492
Corporate family (same tax ID) 1
Practitioners 1
National Provider Directory
- Tax ID family
- Blue and Red Bird Corp PC
Locations
815 W 14th St
Clovis, NM 88101
Phone (505) 462-6492
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 81202 | NM | Yes |
Addresses
Primary practice location
815 W 14TH St
Clovis, NM 88101-5514
Mailing address
815 W 14TH St
Clovis, NM 88101-5514
Phone (575) 762-6492
Other providers in Clovis, NM
- Robert Dale Bitner
- Brittany J Blackmon
- Manuel Blea
- Nicolas Bliss
- Blue and Red Bird Corp PC
- Glenda Clemmer Bly
- Arnel Anthony S Bobadilla
- Tyler Bock
- Samantha V Bohn
- Dayna Lee Bolton
All providers in Clovis, NM · Primary Care Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.