Healthcare Provider Details

I. General information

NPI: 1194827535
Provider Name (Legal Business Name): JOSEPH R ARAGON MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 SANDOVAL
LOS LUNAS NM
87031
US

IV. Provider business mailing address

127 SANDOVAL
LOS LUNAS NM
87031
US

V. Phone/Fax

Practice location:
  • Phone: 505-865-3373
  • Fax: 505-865-2078
Mailing address:
  • Phone: 505-865-3373
  • Fax: 505-865-2078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number81147 NM
License Number StateNM

VIII. Authorized Official

Name: DR. JOSEPH R ARAGON SR.
Title or Position: OWNER PHYSICIAN
Credential: MD
Phone: 505-865-3373