Provider Demographics
NPI:1679909899
Name:PIKEPOND EMERGENCY PHYSICIANS LLC
Entity type:Organization
Organization Name:PIKEPOND EMERGENCY PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF ANCILLARY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:RONAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-495-1240
Mailing Address - Street 1:18167 US HIGHWAY 19 N STE 650
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6576
Mailing Address - Country:US
Mailing Address - Phone:800-507-8874
Mailing Address - Fax:727-536-2896
Practice Address - Street 1:1 ARH LANE
Practice Address - Street 2:
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457
Practice Address - Country:US
Practice Address - Phone:540-862-6011
Practice Address - Fax:540-862-6472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty