Provider Demographics
NPI:1164410148
Name:PEARSON, DREW (DPM)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:
Last Name:PEARSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VALLEY RIVER DR STE 210
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6759
Mailing Address - Country:US
Mailing Address - Phone:541-285-7373
Mailing Address - Fax:877-370-7523
Practice Address - Street 1:1400 VALLEY RIVER DR STE 210
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-600-4630
Practice Address - Fax:877-370-7523
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00366213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR271048Medicaid
OR271048Medicaid