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General NPI Number Information
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NPI Number | 1174160683
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Entity Type | Organization
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Legal Business Name | STEEL CITY PEDIATRICS
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 3934 SANDALWOOD LN
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City | PUEBLO
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State | CO
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Zip | 81005-7503
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Country | US
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Telephone | 719-766-9398
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Fax | 719-766-9399
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Provider Business Mailing Address
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Address Line | 3934 SANDALWOOD LN
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City | PUEBLO
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State | CO
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Zip | 81005-7503
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Country | US
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Telephone | 719-766-9398
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Fax | 719-766-9399
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. JAMES EDWARD SIMONY II
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Credential | MD
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Telephone | 719-766-9398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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