Healthcare Provider Details

I. General information

NPI: 1013966613
Provider Name (Legal Business Name): EMERGENCY PHYSICIANS AT SIERRA VISTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 9TH AVE
TRUTH OR CONSEQUENCES NM
87901-1954
US

IV. Provider business mailing address

PO BOX 42486
PHILADELPHIA PA
19101-2486
US

V. Phone/Fax

Practice location:
  • Phone: 505-894-2111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES L MURPHY
Title or Position: EXE VICE PRESIDENT EPP INC GENER
Credential:
Phone: 800-444-7009