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General NPI Number Information
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NPI Number | 1841244779
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Entity Type | Organization
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Legal Business Name | OPEN MRI OF NEW MEXICO
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2700 FARMINGTON AVE BLDG F2
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City | FARMINGTON
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State | NM
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Zip | 87401-4559
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Country | US
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Telephone | 505-327-6688
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Fax | 505-327-6690
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Provider Business Mailing Address
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Address Line | 2700 FARMINGTON AVE BLDG F2
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City | FARMINGTON
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State | NM
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Zip | 87401-4559
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Country | US
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Telephone | 505-327-6688
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Fax | 505-327-6690
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Authorized Official
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Title or Position | SUPERVISING PHYSICIAN
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Name | DR. FREDERICK J MOSLEY
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Credential | M.D.
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Telephone | 505-327-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Internal Medicine Physician
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License Number | 03-041801-00-1
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License Number State | NM
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