CLOVIS SURGERY CENTER NM LLC NPI 1912512542

NPI Information

  • NPI: 1912512542
  • Provider Name: CLOVIS SURGERY CENTER NM LLC
  • Classification: Orthopaedic Surgery - 207XX0004X
  • Specialization: Foot and Ankle Surgery
  • Entity Type: Organization
  • CLIA Number: 32D2215059
  • Address: 1820 W 21ST ST
    CLOVIS, NM
    ZIP 88101
  • Phone: (575) 935-3668

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NPI Details

CLOVIS SURGERY CENTER NM LLC is a foot and ankle surgery orthopaedic surgery in Clovis, NM. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. CLOVIS SURGERY CENTER NM LLC NPI is 1912512542. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1820 W 21ST ST
CLOVIS, NM
ZIP 88101-024
Phone: (575) 935-3668
Fax: (575) 935-3669

The provider's authorized official is Devin Wahlen .
The authorized official title is Owner and has the following contact phone number (575) 935-3668.

The CLIA number assigned to this NPI record is 32D2215059 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/10/2020 and was last updated on 9/10/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207XX0004XOrthopaedic SurgeryFoot and Ankle SurgeryYes

What is NPI?

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This page was last updated on: 3/30/2025

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