Individual
JUSTIN LYELL HAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4411 MONTANO RD NW, SUITE F, ALBUQUERQUE, NM 87120-3235
(505) 899-4414
(505) 898-2395
Mailing address
4411 MONTANO RD NW, SUITE F, ALBUQUERQUE, NM 87120-3235
(505) 899-4414
(505) 898-2395
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2004-0125
NM
Other
Enumeration date
07/20/2006
Last updated
03/17/2014
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