Andazola, John
Andazola, John is an individual health care provider with primary practice located at 2450 S Telshor Blvd , Las Cruces NM 88011-5069. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Andazola, John can be contacted via phone (575) 521-5370.Contact Information
Primary practice address
2450 S Telshor Blvd
Las Cruces NM 88011-5069
Phone: (575) 521-5370
Fax: (575) 521-5376
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 99-154 | New Mexico |
Profile Details
| NPI number | 1760438196 |
|---|---|
| LBN Legal business name | Andazola, John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2006 |
| Last updated | Apr 11th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760438196 | NPPES |
| New Mexico | Other | P00699013 | RR MEDICARE |
| New Mexico | MEDICAID | 15463357 | RR MEDICARE |
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