| Jason Ryan Mammino, | |
|
4344 Woodlands Blvd Ste 160, Castle Rock, CO 80104-2801 | |
| (303) 350-4500 | |
| Not Available |
| Full Name | Jason Ryan Mammino |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 4344 Woodlands Blvd Ste 160, Castle Rock, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548757073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 0066760 (Colorado) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Advanced Dermatology Of Colorado Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710370648 PECOS PAC ID: 8325337330 Enrollment ID: O20160516000185 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Ryan Mammino, 4344 Woodlands Blvd Ste 160, Castle Rock, CO 80104-2801 Ph: (303) 350-4500 | Jason Ryan Mammino, 4344 Woodlands Blvd Ste 160, Castle Rock, CO 80104-2801 Ph: (303) 350-4500 |
James Daniel Jensen, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4350 Limelight Ave, Suite 205, Castle Rock, CO 80109 Phone: 720-686-7546 Fax: 720-686-7544 | |
Amy M Broomer, D.O. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 755 Maleta Lane, Castle Rock, CO 80108 Phone: 303-688-6355 Fax: 303-688-6876 | |
Allison Marquis, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4350 Limelight Ave Ste 205, Castle Rock, CO 80109 Phone: 720-686-7546 | |
Dr. Jacob Paul Reinhart, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4350 Limelight Ave # 205, Castle Rock, CO 80109 Phone: 720-686-7546 | |
Dr. Tracy A. Haines, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4350 Limelight Ave Ste 205, Castle Rock, CO 80109 Phone: 720-686-7546 Fax: 720-686-7544 | |
David C Hahn, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 4318 Trail Boss Dr, Suite 100, Castle Rock, CO 80104 Phone: 303-338-4545 |