Provider Demographics
NPI:1801261714
Name:ARNETT MEDICAL, LLC
Entity type:Organization
Organization Name:ARNETT MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:POLACO
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-622-7300
Mailing Address - Street 1:1915 N ATKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-7600
Mailing Address - Country:US
Mailing Address - Phone:575-622-7300
Mailing Address - Fax:575-208-7767
Practice Address - Street 1:1915 N ATKINSON AVE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-7600
Practice Address - Country:US
Practice Address - Phone:575-622-7300
Practice Address - Fax:575-208-7767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2002-0302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty