The Pagosa Medical Group LLC

NPI #1497473391 in Durango, Colorado

Provider Information

NPI Number: 1497473391
Entity Type: Organization
Organization Name: The Pagosa Medical Group LLC
Subpart: Yes (part of a larger organization)
Parent Organization: THE PAGOSA MEDICAL GROUP LLC
Primary Specialty: Pediatrics
Enumeration Date: Aug 16, 2022
Last Updated: Aug 16, 2022

Practice Location

Address: 215 E 12TH ST
City: Durango
State: Colorado
ZIP Code: 81301-5206
Phone: (970) 372-0456

Authorized Official

Name: RHONDA L ASH
Title: PRACTICE ADMINISTRATOR
Phone: (970) 372-0456

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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