PHYSICIANS PLAZA SURGERY CENTER, LLC
Ambulatory Health at Hospital Dr, Santa Fe, NM

License number
New Mexico 3233
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: DR. PAUL S FULLERTON D.O.
Title: PRESIDENT
Phone: (505) 955-8420
Address
Address
1631 Hospital Dr STE 100, Santa Fe, NM 87505
National Provider ID: 1619040268
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PHYSICIANS PLAZA SURGERY CENTER, LLC

Santa Fe, NM

Status:
Inactive
Registration:
Dec 19, 2002
Addresses:
123 E Marcy  , Santa Fe, NM 87501 (Mailing)
455 St Michaels Drive  , Santa Fe, NM 87505 (Mailing)
State ID:
2304376
Business type:
Domestic Limited Liability Company
Organizer:
Rachel Goldstein (Organizer)

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