# PHC-LOS ALAMOS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023147097
- **Authorized official:** TERRANCE DILLON (ASSISTANT SECRETARY)
- **Authorized official phone:** (502) 596-7220

## Contact information

- **Practice address:** 3917 WEST RD, LOS ALAMOS, NM 87544-2275
- **Practice address phone:** (505) 662-3452
- **Mailing address:** 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
- **Mailing address phone:** (615) 920-7000
- **Mailing address fax:** (615) 920-8913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |
| 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