Jim P Pederson, PA is a
Physician Assistant - Medical based in Rawlins, Wyoming. Jim P Pederson is licensed to practice in Wyoming (license number 083) and his current practice location is
606 23rd St, Rawlins, Wyoming. He can be reached at his office (for appointments etc.) via phone at
(307) 324-6002.
NPI number for Jim P Pederson is 1902829773 and his current mailing address is 606 23rd St, Rawlins, Wyoming. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1902829773.
Provider's Profile
| Full Name | Jim P Pederson |
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| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 606 23rd St, Rawlins, Wyoming |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1902829773
- Provider Enumeration Date: 07/25/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Jim P Pederson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902829773 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | 083 (Wyoming) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jim P Pederson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jim P Pederson, PA
606 23rd St,
Rawlins, WY 82301-5127
Ph: (307) 324-6002 | Jim P Pederson, PA
606 23rd St,
Rawlins, WY 82301-5127
Ph: (307) 324-6002 |
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