Mallory, Roger Lee
Mallory, Roger Lee is an individual health care provider with primary practice located at 1914 Lelaray St , Colorado Springs CO 80909-2800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Mallory, Roger Lee can be contacted via phone (719) 632-7641.Contact Information
Primary practice address
1914 Lelaray St
Colorado Springs CO 80909-2800
Phone: (719) 632-7641
Fax: (719) 632-2925
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 39036 | Colorado |
Profile Details
| NPI number | 1962488494 |
|---|---|
| LBN Legal business name | Mallory, Roger Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 16th, 2005 |
| Last updated | Feb 11th, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962488494 | NPPES |
| Colorado | MEDICAID | 37275038 |
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