MATHEW THERON SOUTHWICK


Address: 2300 E 30th St Bldg D-101, Farmington, NM 87401-8991
Phone: 5053271400

MATHEW THERON SOUTHWICK (NPI# 1346798204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346798204
Entity Type Individual
Full Name MATHEW THERON SOUTHWICK
Credential P.A.-C.
Practice Address 2300 E 30th St Bldg D-101
Farmington
NM 87401-8991
Practice Telephone 5053271400
Practice Fax Number 5055643202
Mailing Telephone 5053271400
Mailing Fax Number 5055643202
Enumeration Date 2016-09-20
Last Update Date 2016-09-20
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers
N 363AS0400X Physician Assistant
Specialization: Surgical Technologist
Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NM NCCPA 1136642 01

Office Location

Street Address 2300 E 30TH ST BLDG D-101
City FARMINGTON
State NM
Zip Code 87401-8991

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215011218 Bryan Kent Broadbent Podiatrist 2300 E 30th St Bldg D-101, Farmington, NM 87401-8991 2006-10-25
1194955302 Rena Nagl Registered Nurse 2300 E 30th St Bldg D-101, Farmington, NM 87401-8991 2009-07-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164035192 Jaylene Miller Behavior Technician 912 Fairgrounds Rd. Trl 36, Farmington, NM 87401 2020-08-28
1255940326 John Andrew Martinez Behavioral Analyst 211 N Auburn, Farmington, NM 87401 2020-07-24
1598304990 Chasitity Beulah Nez Behavior Technician 37 Rd 7101 #127, Farmington, NM 87401 2020-01-02
1205478575 Micah Magee Speech-Language Pathologist Farmington High School, 2200 N. Sunset Ave, Farmington, NM 87401 2019-10-08
1831659754 Lelilah Todacheene Social Worker 1204 Camina Real, Farmington, NM 87401 2019-03-25
1306323555 Litany of Life Counselor 1010 Ridgeway Place, Farmington, NM 87401 2018-07-20
1093291213 Brittany Bigham Nurse Practitioner 1001 W Broadway Ste E, Farmington, NM 87401 2018-07-11
1528556305 Hairoun Home Health Home Health 1200 East 20th Street, Farmington, NM 87401 2018-04-26
1003338732 Silver Tongue Speech & Voice, LLC Clinic/Center 3001 Northridge Dr Ste C, Farmington, NM 87401 2017-07-14
1902256621 Capacity Builders Inc Taxi 418 W Broadway, Farmington, NM 87401 2016-06-14
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366068538 Lauren Rose Payne Physician Assistant 5610 State Route 96, Farmington, NY 14425-8901 2020-06-23
1003439936 Lisa Petricca Physician Assistant 28 Berkshire Dr, Farmington, CT 06032-2506 2020-05-27
1710544945 Najia Wasiuddin Physician Assistant 35031 Drakeshire Ln Apt 204, Farmington, MI 48335-3220 2019-05-22
1083189880 Sarah E Hudson Physician Assistant 991 Shepard Ln Ste 200, Farmington, UT 84025-2974 2018-10-08
1003307109 Jason S. Pinho Physician Assistant 399 Farmington Ave Ste 110, Farmington, CT 06032-1944 2018-05-23
1659747475 Arsalan Ahsan Physician Assistant 36545 Saxony Rd, Farmington, MI 48335-3022 2015-08-16
1083970297 Elizabeth Ann Putt Physician Assistant 33166 Maplenut St, Farmington, MI 48336-4437 2012-04-02
1275782997 Sarah Marie Zimmerman Physician Assistant 23133 Orchard Lake Rd Ste 100, Farmington, MI 48336-3278 2008-09-17
1104002849 Stephanie Behrens Physician Assistant 21 South Rd Ste 110, Farmington, CT 06032-2482 2008-01-11
1619033388 Kathleen A. Lillicraf Physician Assistant John Dempsey Hospital: Dept of Anesthesiology, 263 Farmington Avenue, Mc-2015, Farmington, CT 06030-0001 2006-12-28
Find all providers in FARMINGTON

Competitor

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City FARMINGTON
Zip Code 87401

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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