Healthcare Provider Details

I. General information

NPI: 1780718155
Provider Name (Legal Business Name): ORTHOPAEDIC BONE & JOINT SPECIALISTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LOMAS BLVD NE ONE WOODWARD CENTER
ALBUQUERQUE NM
87102-2568
US

IV. Provider business mailing address

700 LOMAS BLVD NE ONE WOODWARD CENTER
ALBUQUERQUE NM
87102-2568
US

V. Phone/Fax

Practice location:
  • Phone: 505-242-2764
  • Fax: 505-247-3265
Mailing address:
  • Phone: 505-242-2764
  • Fax: 505-247-3265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberFA0003587
License Number StateNM

VIII. Authorized Official

Name: DR. ALAN L ALTMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 505-242-2764