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SAN JUAN REGIONAL MEDICAL CENTER INC NPI 1528141843


NPI Information

NPI: 1528141843
Provider Name: SAN JUAN REGIONAL MEDICAL CENTER INC

Doing Business As: SAN JUAN REGIONAL NEUROLOGY

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
2300 E 30TH ST
BUILDING 102
FARMINGTON, NM
ZIP 87401
Phone: (505) 609-6790
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SAN JUAN REGIONAL MEDICAL CENTER INC is a neurology psychiatry neurology in Farmington, NM. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. SAN JUAN REGIONAL MEDICAL CENTER INC NPI is 1528141843. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As San Juan Regional Neurology.

The provider's business location address is:

2300 E 30TH ST
BUILDING 102
FARMINGTON, NM
ZIP 87401-990
Phone: (505) 609-6790
Fax: (505) 599-4640

The provider's authorized official is Karen Miller .
The authorized official title is Cfo and has the following contact phone number (505) 609-6025.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 6/29/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
118938868MEDICAIDNEW MEXICO
2900521298MEDICARE PINNEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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