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General NPI Number Information
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NPI Number | 1265308795
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Entity Type | Organization
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Legal Business Name | RURAL PHYSICIANS GROUP - PANNU PLLC
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1311 N MILDRED RD
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City | CORTEZ
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State | CO
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Zip | 81321-2231
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Country | US
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Telephone | 303-390-1940
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Fax | 866-368-6349
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Provider Business Mailing Address
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Address Line | 1311 N MILDRED RD
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City | CORTEZ
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State | CO
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Zip | 81321-2231
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Country | US
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Telephone | 303-390-1940
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Fax | 866-368-6349
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT MANAGER
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Name | LASHAWNA COBB
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Credential |
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Telephone | 303-390-1931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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