Organization
LAS CRUCES PHYSICIAN PRACTICES LLC
Active
Other names
MMC Physician Assistants
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
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/10/2007
Last updated
06/30/2008
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