Pueblo Infectious Diseases, PLLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

PUEBLO INFECTIOUS DISEASES, PLLC

Practice address

St. Mary Corwin Medical Center
1008 Minnequa Ave
Pueblo, CO 81004

Phone

(719) 557-5000

NPI assigned

Sep 14, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Lieberman, MD

Title

Physician

Phone

(719) 369-7767

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261440000000",
    "number": "1275866907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 GUMWOOD DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809067707",
            "telephone_number": "719-369-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. MARY CORWIN MEDICAL CENTER",
            "address_2": "1008 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81004",
            "telephone_number": "719-557-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO INFECTIOUS DISEASES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-12-22",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "719-369-7767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Infectious Disease Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.