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OTERO COUNTY MEDICAL GROUP NPI 1316372352


NPI Information

NPI: 1316372352
Provider Name: OTERO COUNTY MEDICAL GROUP

Doing Business As: CHAMPION MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 32D2287357

Address:
923 9TH ST
SUITE A
ALAMOGORDO, NM
ZIP 88310
Phone: (575) 446-5900
Get Directions

OTERO COUNTY MEDICAL GROUP is a family medicine in Alamogordo, NM. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. OTERO COUNTY MEDICAL GROUP NPI is 1316372352. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Champion Medical Group.

The provider's business location address is:

923 9TH ST
SUITE A
ALAMOGORDO, NM
ZIP 88310-431
Phone: (575) 446-5900

The provider's authorized official is Robert James Heckert .
The authorized official title is Ceo and has the following contact phone number (575) 443-7845.

The CLIA number assigned to this NPI record is 32D2287357 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/10/2013 and was last updated on 9/10/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerNo
2207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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