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NPI Code Detail

MEDICARE: DAVID G FARON PA-C

MEDICARE: DAVID G FARON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant1107NE

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C473508OTHERCOMEDICARE-GROUP

General Provider Information

NPI Number : 1306894464
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID G FARON PA-C
Provider Business Mailing Address
First Line : 2860 S CIRCLE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-4113
Country : US
Telephone Number : 719-540-2100
Fax Number :
Provider Business Practice Location Address
First Line : 5901 CORPORATE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1941
Country : US
Telephone Number : 719-442-6661
Fax Number : 719-598-2775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 03/28/2023

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Directions to “ DAVID G FARON PA-C” Practice Location

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