| Organization Name: | OTERO COUNTY MEDICAL GROUP |
| NPI Number: | 1013342278 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT JAMES HECKERT (CEO) |
| Mailing Address: | 2539 Medical Dr Suite 106 Alamogordo |
| State: | NM US |
| Postal Code: | 883108720 |
| Phone Number: | 5754465300 |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2013 |
| NPI Last Update Date: | 09/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |