MEDICARE: NEW MEXICO CENTER FOR PAIN AND WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	208100000X	Physical Medicine & Rehabilitation Physician
3	207L00000X	Anesthesiology Physician
4	207LA0401X	Addiction Medicine (Anesthesiology) Physician
5	207Q00000X	Family Medicine Physician
6	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1033803143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW MEXICO CENTER FOR PAIN AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	6330 RIVERSIDE PLAZA LN NW STE 100
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2682
Country	:	US
Telephone Number	:	505-322-6687
Fax Number	:	505-369-3406

Provider Business Practice Location Address
First Line	:	6330 RIVERSIDE PLAZA LN NW STE 100
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-2682
Country	:	US
Telephone Number	:	505-322-6687
Fax Number	:	505-369-3406

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTIAN MORRIS
Credential	:
Telephone Number	:	801-891-1038

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	02/20/2024

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Directions to “NEW MEXICO CENTER FOR PAIN AND WELLNESS, LLC ” Practice Location

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