Organization
TRESRIOS PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT OTTESON MD (VICE PRESIDENT)
(505) 327-2930
Entity
Organization
Contact information
Practice address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 327-2930
(505) 599-6290
Mailing address
PO BOX 407, FARMINGTON, NM 87499-0407
(505) 327-2930
(505) 599-6290
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47119
—
NM
Enumeration date
08/25/2006
Last updated
08/22/2020
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