Provider Demographics
NPI:1871680165
Name:PAGEL, JAMES FREDERIC JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FREDERIC
Last Name:PAGEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3065
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-0065
Mailing Address - Country:US
Mailing Address - Phone:719-251-7307
Mailing Address - Fax:
Practice Address - Street 1:1619 N. GREENWOOD
Practice Address - Street 2:SUITE 206
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003
Practice Address - Country:US
Practice Address - Phone:719-584-4297
Practice Address - Fax:719-586-9794
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22744207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01227446Medicaid
COC97559Medicare UPIN
CO01227446Medicaid