# SAN JUAN REGIONAL MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SJHP PHYSIATRY, SJR Interventional Spine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811915234
- **Authorized official:** KIM R HIPSHER-BYRD (CBO DIRECTOR)
- **Authorized official phone:** (505) 609-2258

## Contact information

- **Practice address:** 2500 FARMINGTON AVE, FARMINGTON, NM 87401-4504
- **Practice address phone:** (505) 609-6830
- **Mailing address:** PO BOX 844088, DALLAS, TX 75284-4088
- **Mailing address phone:** (505) 609-2258
- **Mailing address fax:** (505) 609-2259

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 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