Organization
RURAL RADIOLOGY ASSOCIATES TAOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL JOHNSON MD (CO OWNER)
(575) 758-8883
Entity
Organization
Contact information
Practice address
1397 WEIMAR RD, TAOS, NM 87571-6253
(575) 758-8883
(303) 468-1394
Mailing address
12687 W CEDAR DR, 200, LAKEWOOD, CO 80228-2014
(303) 468-1395
(303) 468-1394
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64108236
—
NM
Enumeration date
05/18/2009
Last updated
12/20/2019
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