Organization
SANTA FE TRAIL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY WITHINGTON (PERSONAL REP.)
(505) 647-8366
Entity
Organization
Contact information
Practice address
111 WAVERLY AVE, TRINIDAD, CO 81082-2039
(505) 647-8366
(505) 647-8381
Mailing address
PO BOX 860, TRINIDAD, CO 81082-0860
(505) 647-8366
(505) 647-8381
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/13/2006
Last updated
08/22/2020
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