Casson, Pamela Wallace

Casson, Pamela Wallace is an individual health care provider with primary practice located at 1465 Kelly Johnson Blvd Suite 220, Colorado Springs CO 80920-3955. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Casson, Pamela Wallace can be contacted via phone (719) 265-1050.

Contact Information

Primary practice address
1465 Kelly Johnson Blvd Suite 220 Colorado Springs CO 80920-3955
Fax: (719) 265-2503
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 41888 Colorado

Profile Details

NPI number 1851388367
LBN Legal business name Casson, Pamela Wallace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Feb 11th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851388367 NPPES
Colorado MEDICAID 85487210

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