Healthcare Provider Details

I. General information

NPI: 1043306178
Provider Name (Legal Business Name): NEW MEXICO CARDIOLOGY & ARRYTHMIA CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 E LOHMAN AVE #408
LAS CRUCES NM
88011-8259
US

IV. Provider business mailing address

4351 E LOHMAN AVE #408
LAS CRUCES NM
88011-8259
US

V. Phone/Fax

Practice location:
  • Phone: 505-532-5838
  • Fax:
Mailing address:
  • Phone: 505-532-5838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DEMOSTHENIS KLONIS
Title or Position: PRESIDENT
Credential: D.O.
Phone: 505-532-5838