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Contact Information

JERRY J PAN, MD
1050 W 10TH ST
ROLLA, MO65401
 Phone: 573-364-9000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JERRY J PAN · (Male)

NPI # 1871086769
Status Active
Credentials MD
Entity Individual
Enumeration date 06/14/2018
Last updated 08/13/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2021025566
Hospital affiliation(s)
  • PHELPS COUNTY REGIONAL MEDICAL CENTER - (Acute Care)
    1000 W 10TH ST
    ROLLA, MO 65401
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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