Organization
LAS CRUCES PHYSICIAN PRACTICES, LLC
Active
Other names
MMC Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MANGUM (DIRECTOR PHYSICIAN SERVICES)
(505) 521-5277
Entity
Organization
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(505) 521-5277
Mailing address
PO BOX 6310, LAS CRUCES, NM 88006-6310
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
12/12/2007
Last updated
12/12/2007
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