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General NPI Number Information
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NPI Number | 1194014464
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Entity Type | Individual
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Provider Name | PHIL CODY PEARSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 04/07/2011
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Provider Practice Location Address
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Address Line | 8008 E. ARAPAHOE COURT SUITE 100
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City | CENTENNIAL
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State | CO
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Zip | 80112
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Country | US
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Telephone | 720-529-8060
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Fax | 720-974-7443
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Provider Business Mailing Address
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Address Line | 8008 E. ARAPAHOE COURT SUITE 100
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City | CENTENNIAL
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State | CO
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Zip | 80112
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Country | US
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Telephone | 720-529-8060
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Fax | 720-974-7443
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 23054
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License Number State | CO
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