Doctor Name: | SCOTT W MATTSSON |
NPI Number: | 1194986885 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | LL1887 |
Business Practice Address: | 6071 E Woodmen Rd Suite 340 Colorado Springs, CO - 809232607 |
Business Phone Number: | 7195918100 |
Business Fax Number: | 7195918101 |
Mailing Address: | 6071 E Woodmen Rd, Suite 340 COLORADO SPRINGS |
State: | CO |
Postal Code: | 809232607 |
Phone Number: | 7195918100 |
Fax Number: | 7195918101 |
NPI Enumeration Date: | 06/24/2008 |
NPI Last Update Date: | 09/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | LL1887 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NV |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |