MEDICARE: CHARLES E LEAR MD

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	2084P0800X	Psychiatry Physician	18524	CO
2	2084P0804X	Child & Adolescent Psychiatry Physician	18524	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578520979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES E LEAR MD

Provider Business Mailing Address
First Line	:	PO BOX 40
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81602-0040
Country	:	US
Telephone Number	:	970-945-2241
Fax Number	:	970-945-5523

Provider Business Practice Location Address
First Line	:	515 28 3/4 RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-5016
Country	:	US
Telephone Number	:	970-241-6023
Fax Number	:	970-242-8330

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	12/24/2009

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Directions to “ CHARLES E LEAR MD” Practice Location

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