Organization
SOUTHWEST NEUROSURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD E MAURIN III (OWNER)
(505) 564-8073
Entity
Organization
Contact information
Practice address
555 S SCHWARTZ AVE, FARMINGTON, NM 87401-5955
(505) 564-8076
(505) 324-2259
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 324-2258
(505) 324-2259
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000T8659
—
NM
Enumeration date
07/09/2006
Last updated
10/10/2007
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