Tina J Southward, PAC - Medicare Physician Assistant in Roswell, NM

Tina J Southward, PAC is a medicare enrolled "Physician Assistant - Medical" in Roswell, New Mexico. Her current practice location is 75 Univeristy Blvd, Ste 130, Roswell, New Mexico. You can reach out to her office (for appointments etc.) via phone at (575) 624-7207.

Tina J Southward is licensed to practice in New Mexico (license number 95-PA10) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164434387.

Contact Information

Tina J Southward, PAC
75 Univeristy Blvd, Ste 130,
Roswell, NM 88203
(575) 624-7207
Not Available



Provider's Profile

Full NameTina J Southward
GenderFemale
SpecialityPhysician Assistant - Medical
Location75 Univeristy Blvd, Roswell, New Mexico
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1164434387
  • Provider Enumeration Date: 08/13/2006
  • Last Update Date: 07/12/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 9638273915
  • Enrollment ID: I20070326000363

Medical Identifiers

Medical identifiers for Tina J Southward such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164434387NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 95-PA10 (New Mexico)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tina J Southward is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tina J Southward, PAC
Po Box 1574,
Roswell, NM 88202-1574

Ph: (575) 624-3470
Tina J Southward, PAC
75 Univeristy Blvd, Ste 130,
Roswell, NM 88203

Ph: (575) 624-7207

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Physician Assistant Nurses in Roswell, NM

Mr. Sidney Clyde England, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 402 W Country Club Rd, Roswell, NM 88201
Phone: 575-627-9500    Fax: 575-627-9535
Mark Amba Standley, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 111 W Hobbs St, Roswell, NM 88203
Phone: 575-623-3311    
Mrs. Shannon Ballard Callaway, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 601 W Country Club Rd Ste 201, Roswell, NM 88201
Phone: 575-627-0535    Fax: 575-627-5590
Norman Bowers,
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 303 W Country Club Rd, Roswell, NM 88201
Phone: 505-994-9435    
Rebekah D Carlozzi, PA
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 402 W. Country Club Rd, Roswell, NM 88201
Phone: 575-627-9500    Fax: 575-627-4127
John C Thomas, P.A.
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 115 E 19th St, Roswell, NM 88201
Phone: 575-622-7600    Fax: 575-622-3856

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