Healthcare Provider Details

I. General information

NPI: 1992278360
Provider Name (Legal Business Name): WESTERN MOUNTAIN HOSPITAL PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2669 SCENIC DR
ALAMOGORDO NM
88310-8700
US

IV. Provider business mailing address

PO BOX 3689
SUGAR LAND TX
77487-3310
US

V. Phone/Fax

Practice location:
  • Phone: 575-439-6100
  • Fax:
Mailing address:
  • Phone: 386-274-7800
  • Fax: 833-869-8967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: HARRY KYLE SHEETS
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 888-264-0330