Provider Demographics
NPI:1003998659
Name:PEARSON, ADON L (PA-C)
Entity Type:Individual
Prefix:
First Name:ADON
Middle Name:L
Last Name:PEARSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 NORTH 100 EAST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ST. GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2893
Mailing Address - Country:US
Mailing Address - Phone:435-986-2565
Mailing Address - Fax:435-986-2577
Practice Address - Street 1:168 NORTH 100 EAST
Practice Address - Street 2:SUITE 101
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2893
Practice Address - Country:US
Practice Address - Phone:435-986-2565
Practice Address - Fax:435-986-2577
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1011363A00000X
UT285003-1205363A00000X
AZ3674363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPA1011OtherLICENSE