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NPI Code Detail

MEDICARE: AMANDA SUSANNE IRONS P.A.

MEDICARE: AMANDA SUSANNE IRONS P.A.
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
1363A00000XPhysician AssistantPA.0005276CO
2363A00000XPhysician Assistant0010-03952NC

General Provider Information

NPI Number : 1922132141
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA SUSANNE IRONS P.A.
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-316-7760
Fax Number : 704-316-7761
Provider Business Practice Location Address
First Line : 2222 N NEVADA AVE STE 4007
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6863
Country : US
Telephone Number : 719-776-8500
Fax Number : 719-776-4593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 06/24/2019

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