Organization
LAS CRUCES PHYSICIAN SERVICES LLC
Active
Organization
LAS CRUCES PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SENIOR DIRECTOR, ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
4351 E LOHMAN AVE, SUITE 200, LAS CRUCES, NM 88011-8259
(505) 556-7737
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
2001-213
NM
207X00000X
Orthopaedic Surgery Physician
Primary
77-108
NM
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J0925
—
NM
Enumeration date
02/13/2007
Last updated
01/25/2022
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