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NPI Code Detail

MEDICARE: DR. BRET KYLE PEARCE D.O.

MEDICARE: DR. BRET KYLE PEARCE D.O.
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine PhysicianDO.000307LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346482692
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRET KYLE PEARCE D.O.
Provider Business Mailing Address
First Line : 7047 IMPERIAL WAY
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-1379
Country : US
Telephone Number : 210-872-6188
Fax Number :
Provider Business Practice Location Address
First Line : 7047 IMPERIAL WAY
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-1379
Country : US
Telephone Number : 210-872-6188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2009
Last Update Date : 07/23/2014

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