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PHILLIP THOMAS RAJADAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 S MCCULLOCH BLVD, PUEBLO WEST, CO 81007-2892
(719) 561-5377
(719) 561-5378
Mailing address
PO BOX 8867, PUEBLO, CO 81008-8867
(719) 561-5377
(719) 561-5378

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
39112
CO
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
04-31652
KS
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
39112
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13777777
CO
05
200362640A
KS
01
P00281502
RR MEDICARE
CO
Enumeration date
08/15/2005
Last updated
08/06/2009
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