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Organization
PHC-LOS ALAMOS INC
Active
Organization
PHC-LOS ALAMOS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRANCE DILLON (ASSISTANT SECRETARY)
(502) 596-7220
Entity
Organization
Contact information
Practice address
3917 WEST RD, LOS ALAMOS, NM 87544-2275
(505) 662-3452
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
207RX0202X
Medical Oncology Physician
—
NULL
207RX0202X
Medical Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
Other
Enumeration date
03/05/2007
Last updated
04/25/2022
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