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General NPI Number Information
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NPI Number | 1346586195
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Entity Type | Organization
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Legal Business Name | LAS CRUCES PHYSICIAN PRACTICES, LLC
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Dates
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Enumeration Date | 12/26/2012
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1160 MALL DR SUITE 100
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City | LAS CRUCES
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State | NM
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Zip | 88011-8128
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Country | US
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Telephone | 575-521-3270
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Fax | 575-521-3504
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Provider Business Mailing Address
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Address Line | 1160 MALL DR SUITE 100
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City | LAS CRUCES
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State | NM
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Zip | 88011-8128
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Country | US
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Telephone | 575-521-3270
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Fax | 575-521-3504
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Authorized Official
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Title or Position | SECRETARY
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Name | CHARLOTTE LAWRENCE
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Credential |
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Telephone | 615-920-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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