Highlands Surgical Services LLC
Organization Active NPI Surgery Physician · Clayton, NM
NPI 1164616892 · NPPES record last updated Nov 1, 2007
Key facts
- NPI
- 1164616892
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- License
- MD2007-0129 (NM)
- Legal business name
- HIGHLANDS SURGICAL SERVICES LLC
- Practice address
- 315 N 3Rd Ave
Clayton, NM 88415-3300 - Phone
- (505) 374-2521
- Fax
- (505) 374-2498
- NPI assigned
- Sep 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Sitaramakrishna Kothalanka, MD
- Title
- Owner
- Phone
- (505) 374-2521
National Provider Directory
Locations
315 N 3rd Ave
Clayton, NM 88415
Phone (505) 374-2273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | MD2007-0129 | NM | Yes |
Addresses
Primary practice location
315 N 3Rd Ave
Clayton, NM 88415-3300
Mailing address
315 N 3Rd Ave
Clayton, NM 88415-3300
Phone (505) 374-2521
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184644080 | Other | INDIVIDUAL NPI | |
| 32537034 | Medicaid | NM |
Other providers in Clayton, NM
- Sharon L Gonzales
- Arthur Dean Grine
- Jessica Guthrie
- Robin B Harvey
- Laura Heuchemer Heuchemer
- Cassie Nicole House
- Brianna Irwin
- Anna L Jackard
- Amaris Keeth
- Dharm Atma Singh Khalsa
All providers in Clayton, NM · Surgery Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.