Provider Demographics
NPI:1457320491
Name:PIERSON, DAVID F (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:PIERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4125
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-4125
Mailing Address - Country:US
Mailing Address - Phone:812-537-0417
Mailing Address - Fax:812-537-9418
Practice Address - Street 1:605 WILSON CREEK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1074
Practice Address - Country:US
Practice Address - Phone:812-532-2608
Practice Address - Fax:812-537-0187
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01041999A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100466750Medicaid
IN100466750Medicaid
080088296Medicare PIN
A25777Medicare UPIN
IN178350Medicare PIN