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NPI Code Detail

MEDICARE: PAUL A VAKSELIS MD FACS LLC

MEDICARE: PAUL A VAKSELIS MD FACS LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician2000-120NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831213206
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAUL A VAKSELIS MD FACS LLC
Provider Business Mailing Address
First Line : PO BOX 1560
Second Line :
City : LAS CRUCES
State : NM
Zip : 88004-1560
Country : US
Telephone Number : 505-522-5888
Fax Number : 505-521-1876
Provider Business Practice Location Address
First Line : 2909 HILLRISE DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4701
Country : US
Telephone Number : 505-522-5888
Fax Number : 505-521-1876
Authorized Official
Title or Position : PROVIDER WIFE
Name : SHEILA VAKSELIS
Credential :
Telephone Number : 505-522-5888
Provider Enumeration Date : 03/19/2007
Last Update Date : 05/27/2009

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