NPI 1588057319 · live from the CMS NPI Registry
James Richard Anderson, PA-C
Physician Assistant, Medical in Pueblo, CO. National Provider Identifier 1588057319, active.
NPI record
| NPI | 1588057319 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 3676 Parker Blvd, Pueblo, CO 81008 |
| Practice phone | 719-553-1802 |
| Mailing address | P.O. Box 9000, Southern Colorado Clinic, Pueblo, CO 82008 |
| Enumerated | March 18, 2015 |
| Last updated | December 7, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | PA.0004455 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.