Healthcare Provider Details

I. General information

NPI: 1629040662
Provider Name (Legal Business Name): ALLAN F. RICKMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2539 MEDICAL DR SUITE110 COMPLEX A
ALAMOGORDO NM
88310
US

IV. Provider business mailing address

2539 MEDICAL DR SUITE110 COMPLEX A
ALAMOGORDO NM
88310-8720
US

V. Phone/Fax

Practice location:
  • Phone: 575-434-2116
  • Fax: 575-434-2051
Mailing address:
  • Phone: 575-434-2116
  • Fax: 575-434-2051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number90-282
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: