# SANTA FE TRAIL MEDICAL CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144310871
- **Authorized official:** BETTY WITHINGTON (PERSONAL REP.)
- **Authorized official phone:** (505) 647-8366

## Contact information

- **Practice address:** 111 WAVERLY AVE, TRINIDAD, CO 81082-2039
- **Practice address phone:** (505) 647-8366
- **Practice address fax:** (505) 647-8381
- **Mailing address:** PO BOX 860, TRINIDAD, CO 81082-0860
- **Mailing address phone:** (505) 647-8366
- **Mailing address fax:** (505) 647-8381

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 08/22/2020