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Organization
PHYSICIANS PLAZA SURGERY CENTER, LLC
Active
Organization
PHYSICIANS PLAZA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL S FULLERTON D.O. (PRESIDENT)
(505) 955-8420
Entity
Organization
Contact information
Practice address
1631 HOSPITAL DR STE 100, SANTA FE, NM 87505-4728
(505) 955-8420
(505) 955-8421
Mailing address
1631 HOSPITAL DR STE 100, SANTA FE, NM 87505-4728
(505) 955-8420
(505) 955-8421
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
3233
NM
Other
Enumeration date
11/15/2006
Last updated
06/02/2008
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