Individual
JOHN RANDALL UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 N PENNSYLVANIA AVE STE 570, ROSWELL, NM 88201-4792
(575) 434-0159
(888) 687-6133
Mailing address
2669 SCENIC DR, ALAMOGORDO, NM 88310-8700
(575) 434-0159
(888) 687-6133
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD2019-0235
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78176565
—
NM
Enumeration date
04/18/2006
Last updated
08/22/2019
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