Provider Demographics
NPI:1275808040
Name:NEUROLOGY ASSOCIATES OF MESILLA VALLEY, PC
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES OF MESILLA VALLEY, PC
Other - Org Name:NAMV MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-532-8561
Mailing Address - Street 1:3855 FOOTHILLS RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4772
Mailing Address - Country:US
Mailing Address - Phone:575-532-8561
Mailing Address - Fax:575-532-8567
Practice Address - Street 1:3855 FOOTHILLS RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4772
Practice Address - Country:US
Practice Address - Phone:575-532-8561
Practice Address - Fax:575-532-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM046892471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Multi-Specialty