| NPI | 1316372352 |
|---|---|
| Doing Business As | CHAMPION MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | ROBERT JAMES HECKERT CEO 575-443-7845 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |