Healthcare Provider Details
I. General information
NPI: 1730509191
Provider Name (Legal Business Name): BRIAN HARDY PITTS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/23/2014
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13123 E 16TH AVE
AURORA CO
80045-7106
US
IV. Provider business mailing address
2020 WADSWORTH BLVD STE 16
LAKEWOOD CO
80214-5730
US
V. Phone/Fax
- Phone: 720-777-6131
- Fax:
- Phone: 303-233-8701
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | DR.0058857 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080A0000X |
| Taxonomy | Pediatric Adolescent Medicine Physician |
| License Number | DR.0058857 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: