Provider Demographics
NPI:1790041168
Name:ARTHRITIS TREATMENT SPECIALISTS, LLC
Entity type:Organization
Organization Name:ARTHRITIS TREATMENT SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-526-9189
Mailing Address - Street 1:PO BOX 1268
Mailing Address - Street 2:
Mailing Address - City:MESILLA
Mailing Address - State:NM
Mailing Address - Zip Code:88046-1268
Mailing Address - Country:US
Mailing Address - Phone:575-526-9189
Mailing Address - Fax:575-652-4064
Practice Address - Street 1:1770 TIERRA DE MESILLA
Practice Address - Street 2:
Practice Address - City:LA MESILLA
Practice Address - State:NM
Practice Address - Zip Code:88046
Practice Address - Country:US
Practice Address - Phone:575-526-9189
Practice Address - Fax:575-652-4064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2006-0771207R00000X, 207RR0500X
TXN8041207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM84576863Medicaid
NMNMA 102663Medicare UPIN
NM84576863Medicaid
NM120865Medicare UPIN