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
9348 GRAND CORDERA PKWY, STE 160, COLORADO SPRINGS, CO 80924-7001
(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
47200
CO
207ND0101X
MOHS-Micrographic Surgery Physician
47200
CO
207ND0900X
Dermatopathology Physician
53411
CO
207NP0225X
Pediatric Dermatology Physician
47200
CO
207NS0135X
Procedural Dermatology Physician
47200
CO
207YS0123X
Facial Plastic Surgery Physician
53492
CO
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
53492
CO
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
53492
CO
208200000X
Plastic Surgery Physician
37325
CO
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
37325
CO
Other
Enumeration date
02/03/2009
Last updated
04/01/2024
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