| San Juan Regional Neurology | |
|
2300 E 30th St Building 102 Farmington NM 87401-8990 | |
| (505) 609-6790 | |
| (505) 599-4640 |
| Full Name | San Juan Regional Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2300 E 30th St, Farmington, New Mexico |
| Authorized Official Name and Position | Karen Miller (CFO) |
| Authorized Official Contact | 5056096025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Juan Regional Neurology Po Box 6210 Farmington NM 87499-6210 Ph: (505) 609-2258 | San Juan Regional Neurology 2300 E 30th St Building 102 Farmington NM 87401-8990 Ph: (505) 609-6790 |
| NPI Number | 1528141843 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 06/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528141843 | NPI | - | NPPES |
| 18938868 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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