# JERRY R. PEDERSON, O.D.

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

## Provider details

- **NPI number:** 1811031859
- **Authorized official:** DR. JERRY RAY PEDERSON O.D. (OWNER)
- **Authorized official phone:** (303) 798-5533

## Contact information

- **Practice address:** 6650 S VINE ST, SUITE 160, CENTENNIAL, CO 80121-2735
- **Practice address phone:** (303) 798-5533
- **Practice address fax:** (303) 798-2800
- **Mailing address:** 6650 S VINE ST, SUITE 160, CENTENNIAL, CO 80121-2735
- **Mailing address phone:** (303) 798-5533
- **Mailing address fax:** (303) 798-2800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WC0802X | Corneal and Contact Management Optometrist | 724 | CO | Yes |

## Other

- **Enumeration date:** 02/15/2007
- **Last updated:** 04/17/2008