Pediatric Associates Of Canon City

LBN: Roger D. Noland
Pediatric Associates Of Canon City is an health care organization with primary practice located at 1335 Phay Ave Suite A, Canon City CO 81212-2334. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Roger D. Noland can be contacted via phone (719) 269-1727, or through Noland, Roger Deane via phone (719) 269-1727.

Contact Information

Primary practice address
1335 Phay Ave Suite A Canon City CO 81212-2334
Phone: (719) 269-1727
Fax: (719) 269-1730
Website:
Map and Directions
Authorized official contact:
Name: Noland, Roger Deane MBA, PE
Phone: (719) 269-1727

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X

Profile Details

NPI number 1477608826
LBN Legal business name Roger D. Noland
DBA Doing business as Pediatric Associates Of Canon City
Authorized official Noland, Roger Deane MBA, PE
Entity Organization
Organization subpart 1 No
Enumeration date Jan 24th, 2007
Last updated Jan 27th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477608826 NPPES
Colorado MEDICAID 05638655

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