Organization
RURAL PHYSICIANS GROUP - PANNU PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUKHBIR S PANNU (CEO/OWNER)
(702) 933-3266
Entity
Organization
Contact information
Practice address
1338 PHAY AVE, CANON CITY, CO 81212-2311
(303) 390-1924
Mailing address
5575 DTC PKWY, GREENWOOD VILLAGE, CO 80111-3008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000160748
—
CO
Enumeration date
04/19/2021
Last updated
11/21/2023
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