Individual
JOHN ANDAZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
575 S ALAMEDA BLVD, LAS CRUCES, NM 88005-2818
(575) 528-6400
(575) 521-7199
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
99-154
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15463357
—
NM
01
—
P00699013
RR MEDICARE
NM
Enumeration date
05/26/2006
Last updated
11/21/2024
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