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Organization
PROSTATE CANCER INSTITUTE OF NEW MEXICO PC
Active
Organization
PROSTATE CANCER INSTITUTE OF NEW MEXICO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJAY BHATNAGAR MD (OWNER AND PHYSICIAN)
(520) 360-2895
Entity
Organization
Contact information
Practice address
2300 E 30TH ST STE B-106, FARMINGTON, NM 87401-8991
(505) 421-3144
(505) 421-3145
Mailing address
PO BOX 15088, PHOENIX, AZ 85060-5088
(505) 421-3144
(505) 421-3145
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
08/15/2024
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