Healthcare Provider Details
I. General information
NPI: 1689017584
Provider Name (Legal Business Name): HORIM CHOI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2013
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
702 N 13TH ST
ARTESIA NM
88210-1199
US
IV. Provider business mailing address
702 N 13TH ST
ARTESIA NM
88210-1199
US
V. Phone/Fax
- Phone: 575-748-8301
- Fax: 575-748-8304
- Phone: 575-736-8127
- Fax: 575-748-8540
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | 254527 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | NM2017-0149 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: