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General NPI Number Information
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NPI Number | 1073663043
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Entity Type | Organization
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Legal Business Name | ALAMOGORDO PEDIATRIC ASSOCIATES PC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2559 MEDICAL DR STE A
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8703
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Country | US
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Telephone | 505-434-1500
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Fax | 505-434-1680
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Provider Business Mailing Address
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Address Line | 2559 MEDICAL DR STE A
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8703
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Country | US
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Telephone | 505-434-1500
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Fax | 505-434-1680
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY D STARR
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Credential | MD
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Telephone | 505-434-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | NM012678
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License Number State | NM
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