Individual
LEA PAZOS CREEKMUR O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA, NM 87532-2724
(505) 753-7111
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02003701A
IN
207P00000X
Emergency Medicine Physician
036125848
IL
207P00000X
Emergency Medicine Physician
2011010488
MO
207P00000X
Emergency Medicine Physician
Primary
A-2095-17
NM
Other
Enumeration date
03/13/2009
Last updated
03/17/2018
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