Medical School Information |
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Medical School Name
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UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
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Individual professional's medical school
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Graduation Year
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2006
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Individual professional's medical school graduation year
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Primary Specialty
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MEDICAL ONCOLOGY
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Primary medical specialty reported by the individual professional in the selected enrollment
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Secondary Specialty 1
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HEMATOLOGY
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First secondary medical specialty reported by the individual professional in the selected enrollment
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Secondary Specialty 2
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HEMATOLOGY/ONCOLOGY
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Second secondary medical specialty reported by the individual professional in the selected enrollment
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All Secondary Specialties
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HEMATOLOGY, HEMATOLOGY/ONCOLOGY
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All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas
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Practice Information |
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Organization Legal Name
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NEW MEXICO ONCOLOGY HEMATOLOGY CONSULTANTS LTD
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Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
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Group Practice PAC ID
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3577533447
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Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
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Number of Group Practice members
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35
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Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
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Line 1 Street Address
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2240 COLLEGE DR
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Group Practice or individual's line 1 address
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City
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GALLUP
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Group Practice or individual's city
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State
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NM
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Group Practice or individual's state
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Zip Code
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873017003
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Group Practice or individual's zip code (9 digits when available)
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Phone Number
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5057262400
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Phone number is listed only when there is a single phone number available for the practice location address
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Hospital(s) Affiliation Information |
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Hospital Affiliation CCN 1
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320038
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Medicare CCN of hospital where individual professional provides service 1
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Hospital Affiliation LBN 1
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REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES
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Legal business name of hospital where individual professional provides service 1
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Hospital Affiliation CCN 2
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321308
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Medicare CCN of hospital where individual professional provides service 2
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Hospital Affiliation LBN 2
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CIBOLA GENERAL HOSPITAL
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Legal business name of hospital where individual professional provides service 2
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Hospital Affiliation CCN 3
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320061
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Medicare CCN of hospital where individual professional provides service 3
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Hospital Affiliation LBN 3
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GALLUP INDIAN MEDICAL CENTER
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Legal business name of hospital where individual professional provides service 3
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Hospital Affiliation CCN 4
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320009
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Medicare CCN of hospital where individual professional provides service 4
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Hospital Affiliation LBN 4
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LOVELACE MEDICAL CENTER
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Legal business name of hospital where individual professional provides service 4
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Hospital Affiliation CCN 5
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320021
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Medicare CCN of hospital where individual professional provides service 5
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Hospital Affiliation LBN 5
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PRESBYTERIAN HOSPITAL
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Legal business name of hospital where individual professional provides service 5
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Professional Accepts Medicare Assignment
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Y
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