Organization Name: | LOVELACE HEALTH SYSTEM INC |
NPI Number: | 1902084809 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHEN C PETROVICH (SVP) |
Mailing Address: | 10501 Golf Course Rd Nw Albuquerque |
State: | NM US |
Postal Code: | 871145019 |
Phone Number: | 5057272000 |
Fax Number: | 5057279568 |
NPI Enumeration Date: | 02/04/2008 |
NPI Last Update Date: | 07/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |