Individual
MATHEW THERON SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
2300 E 30TH ST BLDG D-101, FARMINGTON, NM 87401-8991
(505) 327-1400
(505) 564-3202
Mailing address
2300 E 30TH ST BLDG D-101, FARMINGTON, NM 87401-8991
(505) 327-1400
(505) 564-3202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1136642
NCCPA
NM
Enumeration date
09/20/2016
Last updated
09/20/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us