Healthcare Provider Details

I. General information

NPI: 1003362807
Provider Name (Legal Business Name): NEW MEXICO BONE AND JOINT INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2951 N ROADRUNNER PKWY
LAS CRUCES NM
88011-0814
US

IV. Provider business mailing address

2301 INDIAN WELLS RD
ALAMOGORDO NM
88310-4611
US

V. Phone/Fax

Practice location:
  • Phone: 575-526-6515
  • Fax: 575-526-6531
Mailing address:
  • Phone: 575-434-0639
  • Fax: 575-434-4148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLAS DODSON
Title or Position: PRESIDENT
Credential: D.O.
Phone: 575-434-0639