# PHYSICIANS PLAZA SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1619040268
- **Authorized official:** DR. PAUL S FULLERTON D.O. (PRESIDENT)
- **Authorized official phone:** (505) 955-8420

## Contact information

- **Practice address:** 1631 HOSPITAL DR STE 100, SANTA FE, NM 87505-4728
- **Practice address phone:** (505) 955-8420
- **Practice address fax:** (505) 955-8421
- **Mailing address:** 1631 HOSPITAL DR STE 100, SANTA FE, NM 87505-4728
- **Mailing address phone:** (505) 955-8420
- **Mailing address fax:** (505) 955-8421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 3233 | NM | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 06/02/2008