# INDIAN WELLS ULTRASOUND IMAGING INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1215016415
- **Authorized official:** MR. CHARLES JACKSON WOODDELL RDMS (PRESIDENT)
- **Authorized official phone:** (505) 443-0339

## Contact information

- **Practice address:** 205 W BOUTZ RD. BLDG \#1, LAS CRUCES, NM 88005
- **Practice address phone:** (505) 532-7000
- **Practice address fax:** (505) 532-7129
- **Mailing address:** PO BOX 1744, ALAMOGORDO, NM 88311-1744
- **Mailing address phone:** (505) 443-0339
- **Mailing address fax:** (505) 434-5624

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | 106930 | NM | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 07/25/2007