MR. Jerry Rider, PA-C

NPI #1194884494 in Fort Carson, Colorado

Provider Information

NPI Number: 1194884494
Entity Type: Individual
Name: MR. Jerry Rider, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 6, 2006
Last Updated: Jun 13, 2024

Practice Location

Address: 1650 COCHRANE CIR
City: Fort Carson
State: Colorado
ZIP Code: 80913-4613
Phone: (719) 526-2361

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Physician Assistant - Surgical — Surgical	363AS0400X

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