Healthcare Provider Details

I. General information

NPI: 1295793834
Provider Name (Legal Business Name): ROBERT DEAN PEARSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 N NORTHFIELD RD SUITE 200
CEDAR CITY UT
84720-7744
US

IV. Provider business mailing address

1251 NORTHFIELD RD SUITE 200
CEDAR CITY UT
84720-8622
US

V. Phone/Fax

Practice location:
  • Phone: 435-867-8719
  • Fax: 435-867-5763
Mailing address:
  • Phone: 435-867-8719
  • Fax: 435-867-5763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number370728-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number370728-1205
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: