MEDICARE: DR. PETER SYKORA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	CDRH.0058899	CO

General Provider Information

NPI Number	:	1366795080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER SYKORA D.O.

Provider Business Mailing Address
First Line	:	1600 N GRAND AVE STE 520
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-2757
Country	:	US
Telephone Number	:	719-562-2360
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 N GRAND AVE STE 520
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-2757
Country	:	US
Telephone Number	:	719-562-2360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	01/25/2026

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