Individual
DR. GARRY D PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2511 W EDGEWOOD DR, SUITE F, JEFFERSON CITY, MO 65109-5869
(573) 761-2130
(573) 761-6957
Mailing address
2511 W EDGEWOOD DR, SUITE F, JEFFERSON CITY, MO 65109-5869
(573) 761-2130
(573) 761-6957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
105089
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246900401
—
MO
Enumeration date
06/14/2006
Last updated
08/06/2012
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