Provider Demographics
NPI:1215293782
Name:PEARSON, KELLY CATHRYN (MD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:CATHRYN
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:20201 N SCOTTSDALE HEALTHCARE DR
Mailing Address - Street 2:STE 260
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4140
Mailing Address - Country:US
Mailing Address - Phone:480-398-1550
Mailing Address - Fax:480-398-1551
Practice Address - Street 1:20201 N SCOTTSDALE HEALTHCARE DR
Practice Address - Street 2:STE 260
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4140
Practice Address - Country:US
Practice Address - Phone:480-398-1550
Practice Address - Fax:480-398-1551
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2017-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ51475207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology