Provider Demographics
NPI:1023635117
Name:POLLOCK, BYRON (SA)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:
Last Name:POLLOCK
Suffix:
Gender:M
Credentials:SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10798 MADISON WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4482
Mailing Address - Country:US
Mailing Address - Phone:303-828-6470
Mailing Address - Fax:
Practice Address - Street 1:10798 MADISON WAY
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-4482
Practice Address - Country:US
Practice Address - Phone:303-828-6470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant