Organization
ZIA MEDICAL GROUP LLC
Active
Other names
ZMG
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD OTHMAN MD (MANAGER)
(312) 813-6958
Entity
Organization
Contact information
Practice address
233 FAIRWAY TER N STE B, CLOVIS, NM 88101-3060
(575) 762-7779
(575) 762-3526
Mailing address
PO BOX 5032, CLOVIS, NM 88102-5032
(575) 762-7779
(575) 762-3526
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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