Organization
VANGUARD MEDICAL SPECIALISTS, LLC
Active
Other names
Vanguard Skin Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER GUST-ALLEN (REVENUE CYCLE MANAGER)
(719) 465-5643
Entity
Organization
Contact information
Practice address
6215 CORPORATE DR, COLORADO SPRINGS, CO 80919-1917
(719) 355-1585
(719) 623-2983
Mailing address
PO BOX 5088, DENVER, CO 80217-5088
(719) 355-1585
(719) 623-2983
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
208200000X
Plastic Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/03/2023
Last updated
04/01/2024
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