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Organization
LAS CRUCES PHYSICIAN PRACTICES LLC
Active
Organization
LAS CRUCES PHYSICIAN PRACTICES LLC
Active
Other names
MMC Physician Assistants
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MANGUM (DIRECTOR PHYSICIAN SERVICES)
(505) 521-5277
Entity
Organization
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(505) 521-5277
Mailing address
PO BOX 6310, LAS CRUCES, NM 88006-6310
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/10/2007
Last updated
06/30/2008
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