Organization
PATHOLOGY CONSULTANTS OF NEW MEXICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MOORES (CEO/ MANAGING PARTNER)
(575) 622-5600
Entity
Organization
Contact information
Practice address
600 N RICHARDSON AVE, ROSWELL, NM 88201-4828
(505) 622-5600
(505) 622-3720
Mailing address
600 N RICHARDSON AVE, ROSWELL, NM 88201-4828
(505) 622-5600
(505) 622-3720
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52837
—
NM
Enumeration date
12/16/2005
Last updated
06/05/2020
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