Moffitt, Suzelle L
Moffitt, Suzelle L is an individual health care provider with primary practice located at 121 El Paso Rd , Ruidoso NM 88345-6033. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Moffitt, Suzelle L can be contacted via phone (575) 630-8350.Contact Information
Primary practice address
121 El Paso Rd
Ruidoso NM 88345-6033
Phone: (575) 630-8350
Fax: (575) 257-4055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | H5566 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD2017-0489 | New Mexico |
Profile Details
| NPI number | 1083677793 |
|---|---|
| LBN Legal business name | Moffitt, Suzelle L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Jul 21st, 2022 - about 2 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 | 1083677793 | NPPES |
| New Mexico | MEDICAID | 21107831 | |
| New Mexico | Other | 8GA072 |
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