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General NPI Number Information
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NPI Number | 1104971886
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Entity Type | Individual
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Provider Name | HERBERT V RACHELSON MD
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | ESPANOLA MULTI-SPECIALTY CLINIC 1010 SPRUCE ST
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City | ESPANOLA
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State | NM
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Zip | 87532
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Country | US
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Telephone | 505-367-0340
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Fax | 505-367-0346
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone | 505-923-5356
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Fax | 505-923-5354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 76-249
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 76-249
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License Number State | NM
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