Provider Demographics
NPI:1477031094
Name:HOSPITALIST MEDICINE PHYSICIANS OF NEW MEXICO - CLOVIS, LLC
Entity Type:Organization
Organization Name:HOSPITALIST MEDICINE PHYSICIANS OF NEW MEXICO - CLOVIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRYSHINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-543-8559
Mailing Address - Street 1:120 BRENTWOOD COMMONS WAY STE 510
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2028
Mailing Address - Country:US
Mailing Address - Phone:615-371-5778
Mailing Address - Fax:
Practice Address - Street 1:4900 N LOVINGTON HWY
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-9109
Practice Address - Country:US
Practice Address - Phone:575-492-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty