NPI 1457498131

Pediatric Associates of Canon City, Prof. LLC

Organisation Pediatric Adolescent Medicine Physician Canon City, CO

Practice location

Address: 1335 Phay Ave Suite a, Canon City, CO 81212-2334
Phone: (719) 269-1727
Fax: (719) 269-1730

Authorised official

Name: Roger Deane Noland
Title: General Manager
Phone: (719) 269-1727

Registered specialties

Pediatric Adolescent Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2080A0000X Licence 23117 (CO)

Other Pediatrics providers in Colorado →

Registry record

NPI: 1457498131
Entity type: Organization
NPI issued: 31 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.