Provider Demographics
NPI:1336413210
Name:ROSSIGNOL, PAUL R (DOM, DIPL OM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
Last Name:ROSSIGNOL
Suffix:
Gender:M
Credentials:DOM, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 ALVARADO DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4020
Mailing Address - Country:US
Mailing Address - Phone:505-363-4626
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERISTY OF NEW MEXICO UNM STUDENT HEALTH CENTER
Practice Address - Street 2:BUILDING 73 MSC06 3870
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131
Practice Address - Country:US
Practice Address - Phone:505-277-9866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM911171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist