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SAN JUAN ONCOLOGY ASSOCIATES PC NPI 1558446187


NPI Information

NPI: 1558446187
Provider Name: SAN JUAN ONCOLOGY ASSOCIATES, PC
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 32D1025903

Address:
2325 E 30TH ST
FARMINGTON, NM
ZIP 87401
Phone: (505) 564-6850
Get Directions

SAN JUAN ONCOLOGY ASSOCIATES, PC is a hematology and oncology internal medicine in Farmington, NM. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. SAN JUAN ONCOLOGY ASSOCIATES, PC NPI is 1558446187. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2325 E 30TH ST
FARMINGTON, NM
ZIP 87401-900
Phone: (505) 564-6850
Fax: (505) 564-6890

The provider's authorized official is Jeffrey D Neidhart .
The authorized official title is Md, Ceo and has the following contact phone number (505) 564-6850.

The CLIA number assigned to this NPI record is 32D1025903 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/25/2006 and was last updated on 6/24/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyYes
2207RX0202XInternal MedicineMedical OncologyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1788664MEDICAIDARIZONA
2PROVP23839OTHERNEW MEXICOCIMMARON SALUD MOLINA
3700521049OTHERNEW MEXICOMEDICARE TRAILBLAZERS
4020403599OTHERNEW MEXICOENERGY EMPLOYEES OCCU
530179882MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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