Healthcare Provider Details

I. General information

NPI: 1235385303
Provider Name (Legal Business Name): ASSOCIATED PHYSICIANS & PRACTITIONERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 W 21ST ST
CLOVIS NM
88101-4023
US

IV. Provider business mailing address

1833 W 21ST ST
CLOVIS NM
88101-4023
US

V. Phone/Fax

Practice location:
  • Phone: 575-763-5585
  • Fax: 575-763-5160
Mailing address:
  • Phone: 575-763-5585
  • Fax: 575-763-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number82.61
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number82.61
License Number StateNM

VIII. Authorized Official

Name: DR. STEPHEN H HAYNES
Title or Position: MEMBER
Credential: M.D.
Phone: 575-763-9800