Healthcare Provider Details

I. General information

NPI: 1255682944
Provider Name (Legal Business Name): ARMSTRONG MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2012
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13170 CENTRAL AVE SE SUITE B 345
ALBUQUERQUE NM
87123
US

IV. Provider business mailing address

13170 CENTRAL AVE SE SUITE B 345
ALBUQUERQUE NM
87123
US

V. Phone/Fax

Practice location:
  • Phone: 505-620-6319
  • Fax:
Mailing address:
  • Phone: 505-620-6319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number98-PA09
License Number StateNM

VIII. Authorized Official

Name: PAUL LEE ARMSTRONG
Title or Position: OWNER / DIRECTOR
Credential: PA
Phone: 505-620-6319