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Individual

SHANNON CLAYE WEBB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
IVY CLINIC - BUILDING 7503, 1650 COCHRANE CIRCLE, FORT CARSON, CO 80913
(719) 524-4068
(719) 526-7132
Mailing address
5818 VILLA LORENZO DR, COLORADO SPRINGS, CO 80919-5415
(864) 494-2134

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22749
SC
207Q00000X
Family Medicine Physician
D0091535
MD
207Q00000X
Family Medicine Physician
Primary
DR0071691
CO

Other

Enumeration date
11/30/2005
Last updated
11/20/2024
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