Provider Demographics
NPI:1063791176
Name:PITTS, ERIC (PA-C)
Entity type:Individual
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First Name:ERIC
Middle Name:
Last Name:PITTS
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:2101 KIMBALL AVE
Mailing Address - Street 2:LL14
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5063
Mailing Address - Country:US
Mailing Address - Phone:319-272-1590
Mailing Address - Fax:319-272-1535
Practice Address - Street 1:516 DIVISION ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2382
Practice Address - Country:US
Practice Address - Phone:319-268-3550
Practice Address - Fax:319-268-3855
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2015-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL1111733363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant