Provider Demographics
NPI:1669570768
Name:TYRRELL, PAMELA FRANCES (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:FRANCES
Last Name:TYRRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 BELLAIRE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3023
Mailing Address - Country:US
Mailing Address - Phone:303-399-5081
Mailing Address - Fax:303-399-6025
Practice Address - Street 1:2600 BELLAIRE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-3023
Practice Address - Country:US
Practice Address - Phone:720-840-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30365207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO61271896Medicaid
COF23860Medicare UPIN
CO61271896Medicaid