Provider Demographics
NPI:1235135690
Name:WEBB, SIDNEY FARRINGTON (MD)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:FARRINGTON
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1100 S MAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2952
Mailing Address - Country:US
Mailing Address - Phone:505-526-1105
Mailing Address - Fax:505-524-4266
Practice Address - Street 1:ONATE PLAZA
Practice Address - Street 2:SUITE 7
Practice Address - City:MESILLA
Practice Address - State:NM
Practice Address - Zip Code:88046
Practice Address - Country:US
Practice Address - Phone:505-524-3571
Practice Address - Fax:505-525-8089
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM74-107207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM06536Medicaid
NM06536Medicaid