Mellott, Ann L

Mellott, Ann L is an individual health care provider with primary practice located at 4110 Briargate Pkwy Suite 465, Colorado Springs CO 80920-7835. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Mellott, Ann L can be contacted via phone (719) 365-6568.

Contact Information

Primary practice address
4110 Briargate Pkwy Suite 465 Colorado Springs CO 80920-7835
Phone: (719) 365-6568
Fax: (719) 364-3582
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 036096502 Illinois
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X DR.0056052 Colorado

Profile Details

NPI number 1194704262
LBN Legal business name Mellott, Ann L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Dec 8th, 2015 - about 11 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 1194704262 NPPES
Illinois MEDICAID 036096502

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