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Individual

PAUL A VAKSELIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2909 HILLRISE DR, LAS CRUCES, NM 88011-4701
(505) 522-5888
(505) 521-1876
Mailing address
PO BOX 1560, LAS CRUCES, NM 88004-1560
(505) 647-8366
(505) 647-8387

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2000120
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020049262
RR MEDICARE
NM
01
31557
LOVELACE
NM
01
54770
PRESBYTERIAN
NM
05
74423
NM
01
850460870
CIMARRON SALUD
NM
01
850466870
CHAMPUS
NM
01
880110001
WPS TRICARE
NM
01
NM009426
BC/BS
NM
Enumeration date
09/01/2005
Last updated
02/10/2009
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