Healthcare Provider Details

I. General information

NPI: 1336413210
Provider Name (Legal Business Name): PAUL R ROSSIGNOL D.O.M., DIPL. OM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2012
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERISTY OF NEW MEXICO UNM STUDENT HEALTH CENTER BUILDING 73 MSC06 3870
ALBUQUERQUE NM
87131
US

IV. Provider business mailing address

1 UNIVERISTY OF NEW MEXICO UNM STUDENT HEALTH CENTER BUILDING 73 MSC06 3870
ALBUQUERQUE NM
87131-0001
US

V. Phone/Fax

Practice location:
  • Phone: 505-277-9866
  • Fax:
Mailing address:
  • Phone: 505-277-9866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number911
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: