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General NPI Number Information
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NPI Number | 1427490424
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Entity Type | Organization
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Legal Business Name | ANESTHESIA SERVICES OF ALBUQUERQUE
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 9551 PASEO DEL NORTE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2975
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Country | US
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Telephone | 505-639-4640
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 670382
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City | DALLAS
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State | TX
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Zip | 75267-0382
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Country | US
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Telephone | 503-372-2740
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN T DIXON
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Credential | MD
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Telephone | 505-299-2350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 89-28
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License Number State | NM
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