Organization · Type 2 NPI

San Juan Regional Medical Center Inc

Obstetrics & Gynecology Physician · Farmington, NM

NPI number 1124262415 Active

Practice location

655 W Pinon St
Farmington, NM 87401-5973

Call (505) 609-2590 Map

Fax (505) 609-2595

Mailing address

PO Box 844088
Dallas, TX 75284-4088

Other practice locations

634 W Pinon St, Farmington, NM 87401-5915 · (505) 325-4898
610 W Pinon St, Farmington, NM 87401-5974 · (505) 325-1123

Specialties and licenses

Taxonomy	Code	License
Obstetrics & Gynecology Physician Primary	207V00000X	None listed
Obstetrics & Gynecology Nurse Practitioner	363LX0001X	None listed

Obstetrics & Gynecology Physician: An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

4 other providers at this address

Other obstetrics & gynecology physician providers in Farmington

See all in Farmington →

NPI record

NPI: 1124262415
Entity type: Organization (Type 2)
Issued: Apr 30, 2009
Last updated: Jul 16, 2025
Status: Active
Subpart: Yes of San Juan Regional Medical Center Inc

Other names

<unavail>
San Juan Regional Midwifery & Womens Health Center · doing business as
San Juan Regional Midwifery & Womens Health Center · doing business as
SJHP Ob & Gyn 610 · doing business as
SJHP Ob & Gyn 634 · doing business as

Authorized official

Kim Byrd
Administrative Director of Reimburs
(505) 609-2258

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1124262415

San Juan Regional Medical Center Inc's National Provider Identifier is 1124262415, issued on Apr 30, 2009. The primary taxonomy on file is Obstetrics & Gynecology Physician (207V00000X), and the practice location is in Farmington, NM. The record was last updated on Jul 16, 2025.