Organization
SOUTHWEST GYNECOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA L COALSON MD (PRESIDENT)
(505) 410-7288
Entity
Organization
Contact information
Practice address
780 S WALNUT ST BLDG 1, LAS CRUCES, NM 88001-1425
(575) 521-1889
Mailing address
780 S WALNUT ST BLDG 1, LAS CRUCES, NM 88001-1425
(575) 521-1889
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD2012-0250
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5446317
NEW MEXICO BUSINESS ID (CRS#)
NM
01
—
MD2012-0250
MEDICAL LICENSE NUMBER
NM
Enumeration date
07/14/2017
Last updated
07/21/2022
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