# RURAL PHYSICIANS GROUP - PANNU PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265308795
- **Authorized official:** LASHAWNA COBB (PROVIDER ENROLLMENT MANAGER)
- **Authorized official phone:** (303) 390-1931

## Contact information

- **Practice address:** 1311 N MILDRED RD, CORTEZ, CO 81321-2231
- **Practice address phone:** (303) 390-1940
- **Practice address fax:** (866) 368-6349
- **Mailing address:** 1311 N MILDRED RD, CORTEZ, CO 81321-2231
- **Mailing address phone:** (303) 390-1940
- **Mailing address fax:** (866) 368-6349

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | Yes |
| 208M00000X | Hospitalist Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2025
- **Last updated:** 10/13/2025