Individual
ELIZABETH S LYCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2101 KEN PRATT BLVD STE 104G, LONGMONT, CO 80501-6568
(303) 415-4246
(303) 415-8407
Mailing address
PO BOX 9049, BOULDER, CO 80301-9049
(303) 415-4155
(303) 776-3109
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DR.0055112
CO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
DR.0055112
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37323849
—
CO
Enumeration date
03/29/2010
Last updated
09/30/2024
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