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Organization
SAN JUAN REGIONAL MEDICAL CENTER, INC.
Active
Organization
SAN JUAN REGIONAL MEDICAL CENTER, INC.
Active
Other names
SJHP PHYSIATRY, SJR Interventional Spine
Organization subpart
No
Provider details
NPI number
Authorized official
KIM R HIPSHER-BYRD (CBO DIRECTOR)
(505) 609-2258
Entity
Organization
Contact information
Practice address
2500 FARMINGTON AVE, FARMINGTON, NM 87401-4504
(505) 609-6830
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
07/17/2006
Last updated
07/16/2025
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