Organization
SOUTHWEST UROLOGY SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER GIST MD (OWNER/PRESIDENT)
(607) 743-3714
Entity
Organization
Contact information
Practice address
4161 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-6742
(607) 743-3714
Mailing address
1380 RIO RANCHO DR SE # 349, RIO RANCHO, NM 87124-1006
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
10/27/2021
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