Organization
PHC LAS CRUCES
Active
Other names
MMC Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MANGUM (DIRECTOR)
(575) 521-5277
Entity
Organization
Contact information
Practice address
2530 S TELSHOR BLVD, SUITE 201, LAS CRUCES, NM 88011-4907
(575) 521-5277
Mailing address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 521-5277
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26001373
—
NM
Enumeration date
08/06/2009
Last updated
08/06/2009
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