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ISPM - NEW MEXICO LLC NPI 1861633307


NPI Information

NPI: 1861633307
Provider Name: ISPM - NEW MEXICO LLC

Doing Business As: INTERVENTIONAL SPINE AND PAIN MGMT.

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D2098274

Address:
2474 INDIAN WELLS RD.
ALAMOGORDO, NM
ZIP 88310
Phone: (415) 987-4921
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ISPM - NEW MEXICO LLC is a specialist in Alamogordo, NM. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ISPM - NEW MEXICO LLC NPI is 1861633307. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Interventional Spine And Pain Mgmt..

The provider's business location address is:

2474 INDIAN WELLS RD.
ALAMOGORDO, NM
ZIP 88310-700
Phone: (415) 987-4921
Fax: (575) 437-0358

The provider's authorized official is Brett Lynn Butz .
The authorized official title is Owner/president and has the following contact phone number (415) 987-4921.

The CLIA number assigned to this NPI record is 05D2098274 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2009 and was last updated on 3/11/2021.


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
1174400000XSpecialistMD2009-0017NEW MEXICOYes

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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