Organization
LINCOLN COUNTY RADIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD A. WOLFEL MD (PRESIDENT)
(575) 532-7000
Entity
Organization
Contact information
Practice address
211 SUDDERTH DR, RUIDOSO, NM 88345
(575) 257-8200
Mailing address
205 W BOUTZ RD, BLDG 1, LAS CRUCES, NM 88005
(575) 532-7000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22285
—
NM
01
—
DG0346
RR MEDICARE
—
Enumeration date
08/11/2006
Last updated
06/30/2009
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