Organization
SOUTHWESTERN PROVIDER SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT RAY FRANTZ JR. MD (PRESIDENT)
(865) 693-1000
Entity
Organization
Contact information
Practice address
6400 PASEO DEL NORTE, ALBUQUERQUE, NM 87113
(865) 693-1000
Mailing address
265 BROOKVIEW CENTRE WAY STE 400, KNOXVILLE, TN 37919-4052
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
—
—
163WP2201X
Ambulatory Care Registered Nurse
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
03/18/2019
Last updated
01/10/2020
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