Organization
OTERO COUNTY MEDICAL GROUP
Active
Parent organization
OTERO COUNTY MEDICAL GROUP
Other names
Champion Cancer Center of Otero County
Organization subpart
Yes
Provider details
NPI number
Legal business name
OTERO COUNTY MEDICAL GROUP
Authorized official
MR. ROBERT JAMES HECKERT FACHE (CEO)
(575) 443-7845
Entity
Organization
Contact information
Practice address
2559 MEDICAL DR, SUITE G, ALAMOGORDO, NM 88310-8703
(575) 437-8126
Mailing address
2689 SCENIC DR, ALAMOGORDO, NM 88310-8700
(575) 434-1699
(575) 434-8871
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
364SM0705X
Medical-Surgical Clinical Nurse Specialist
—
—
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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