Organization
SOUTHWEST MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN C. PETROVICH (EVP, GENERAL COUNSEL)
(615) 296-3594
Entity
Organization
Contact information
Practice address
1627 S UNION AVE, ROSWELL, NM 88203-2656
(575) 625-3240
Mailing address
340 SEVEN SPRINGS WAY STE 100, BRENTWOOD, TN 37027-5697
(615) 296-3594
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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