Individual
MICHAEL G PHARRIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2857 E FOUNTAIN BLVD, COLORADO SPRINGS, CO 80910-2312
(719) 329-1221
(719) 329-1511
Mailing address
2221 EAST BIJOU, SUITE 100, COLORADO SPRINGS, CO 80909
(719) 576-1850
(719) 955-3470
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1462
CO
152WP0200X
Pediatric Optometrist
Primary
1462
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08014623
—
CO
05
—
21351821
—
CO
Enumeration date
11/16/2006
Last updated
10/20/2021
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