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Individual

PETER L DRISCOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
121 EL PASO RD, LINCOLN COUNTY MEDICAL COMPLEX, RUIDOSO, NM 88345-6033
(575) 630-8350
(575) 630-5232
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
86034
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37044
NM
Enumeration date
10/04/2006
Last updated
10/30/2015
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