Organization
SAN JUAN REGIONAL MEDICAL CENTER INC
Active
Other names
San Juan Regional Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BYRD (ADMINISTRATIVE DIRECTOR OF REIMBUR)
(505) 609-2258
Entity
Organization
Contact information
Practice address
2300 E 30TH ST, BUILDING 102, FARMINGTON, NM 87401-8990
(505) 609-6790
(505) 599-4640
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18938868
—
NM
Enumeration date
10/23/2006
Last updated
07/16/2025
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