National Provider Identifier Database

PHC LAS CRUCES
Hematology & Oncology

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.


Contact Information

PHC LAS CRUCES
2530 S TELSHOR BLVD
SUITE 201
LAS CRUCES, NM88011-4907
Phone: 575-521-5277
Fax:
Website:
Specialty Taxonomy Code
* Hematology & Oncology 207RH0003X

* Indicates primary specialty

NPI Profile & details for PHC LAS CRUCES

NPI Number 1376774489
Legal business name
LBN
PHC LAS CRUCES
Authorized official ANGIE MANGUM - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 08/06/2009
Last updated 08/06/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • NM Medicaid: 26001373

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PHC LAS CRUCES

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