Organization
ROSWELL HOSPITAL
Active
Other names
Eastern New Mexico Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL PORTACCI (GROUP VP)
(615) 465-7000
Entity
Organization
Contact information
Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 622-8170
(505) 624-8751
Mailing address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 622-8170
(505) 624-8751
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2002-0076
NM
Other
Enumeration date
07/12/2006
Last updated
08/22/2020
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