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DR. PETER C HARRELSON MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1578685442

Individual Registrant:
DR. PETER C HARRELSON MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
421 WEST ADAMS  NATURITA, CO 81422-0340 US
Tel: 970-865-2665  Fax: 970-865-2674

Contact information for business:
PO BOX 340  NATURITA, CO 81422-0340 US
Tel: 970-865-2665  Fax: 970-865-2674

Registration Information:
NPI: 1578685442
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CO27356

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICARE PTAN FOR BASIN CLINC422496ZJGQCO01
RAILROAD WORKERS MEDICARE PTAN FOR BASIN CLINICP01512719CO01
08439869CO05
22530380NM05
094973AZ05




HEALTH CARE JOBS CO - Page 1



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