PEDIATRIC ASSOCIATES OF CANON CITY PROF. LLC NPI 1457498131

NPI Information

PEDIATRIC ASSOCIATES OF CANON CITY, PROF. LLC is an adolescent medicine pediatrics in Canon City, CO. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. PEDIATRIC ASSOCIATES OF CANON CITY, PROF. LLC NPI is 1457498131. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1335 PHAY AVE
SUITE A
CANON CITY, CO
ZIP 81212-334
Phone: (719) 269-1727
Fax: (719) 269-1730

The provider's authorized official is Roger Deane Noland .
The authorized official title is General Manager and has the following contact phone number (719) 269-1727.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.