Southwest Obstetrics and Gynecology, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD2007-0662 Issued in NM

Legal business name

SOUTHWEST OBSTETRICS AND GYNECOLOGY, LLC

Practice address

634 W Pinon St
Farmington, NM 87401-5915

Phone

(505) 325-4898

Fax

(505) 325-7898

NPI assigned

Oct 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Allen Fisher, MD

Title

Owner

Phone

(505) 325-4898

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12045/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1710176995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 W PINON ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015915",
            "telephone_number": "505-325-4898",
            "fax_number": "505-325-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 W PINON ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015915",
            "telephone_number": "505-325-4898",
            "fax_number": "505-325-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST OBSTETRICS AND GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-325-4898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2007-0662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12986062",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Farmington, NM
• Providers in Farmington, NM by specialty
• Obstetrics & Gynecology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.