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General NPI Number Information
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NPI Number | 1225065527
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 612 N 13TH ST
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City | ARTESIA
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State | NM
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Zip | 88210-1167
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Country | US
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Telephone | 505-748-8356
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Fax | 505-748-8305
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Provider Business Mailing Address
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Address Line | PO BOX 629
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City | ARTESIA
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State | NM
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Zip | 88211-0629
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Country | US
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Telephone | 505-748-8356
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Fax | 505-748-8305
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Authorized Official
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Title or Position | CEO
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Name | KENNETH W RANDALL
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Credential |
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Telephone | 505-748-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NM
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NM
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