Organization
NEW MEXICO ORTHOPAEDIC SURGERY CENTER, LLC
Active
Other names
New Mexico Surgery Center Orthopaedics
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-2300
(505) 291-2299
Mailing address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 357-3072
(505) 213-0583
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
3002
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00062743
—
NM
01
—
490004602
RAILROAD MEDICARE
NM
01
—
SS23
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/08/2006
Last updated
09/13/2024
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