Healthcare Provider Details

I. General information

NPI: 1669570768
Provider Name (Legal Business Name): PAMELA FRANCES TYRRELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 BELLAIRE ST
DENVER CO
80207-3023
US

IV. Provider business mailing address

2600 BELLAIRE ST
DENVER CO
80207-3023
US

V. Phone/Fax

Practice location:
  • Phone: 720-840-5031
  • Fax:
Mailing address:
  • Phone: 303-399-5081
  • Fax: 303-399-6025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number30365
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: