Organization
NEW MEXICO MEDICAL SURGICAL HOSPITAL LLC
Active
Other names
Roswell Regional Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN C. PETROVICH (SENIOR VICE PRESIDENT)
(615) 296-3000
Entity
Organization
Contact information
Practice address
2335 N MAIN ST, ROSWELL, NM 88201-6452
(575) 622-4665
(575) 622-4557
Mailing address
2335 N MAIN ST, ROSWELL, NM 88201-6452
(575) 622-4665
(575) 622-4557
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7707576
—
NM
Enumeration date
03/24/2010
Last updated
03/16/2012
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