Ingenious Personalized Medicine, LLC

Organization Active NPI Clinical Medical Laboratory · Colorado Springs, CO

NPI 1083280978 · NPPES record last updated Jan 9, 2023

Key facts

NPI
1083280978
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
INGENIOUS PERSONALIZED MEDICINE, LLC
Practice address
6915 Tutt Boulevard
Suite 110a
Colorado Springs, CO 80923-3591
Phone
(786) 221-1734
Fax
(305) 891-4228
NPI assigned
Jun 1, 2021
Organization subpart
No

Authorized official

Name
Scott Daniel Segal, MD NPI 1821086323
Title
Ceo
Phone
(888) 852-6672

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Ingenious Personalized Medicine LLC (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

6915 Tutt Boulevard
Suite 110a
Colorado Springs, CO 80923-3591

Mailing address

1065 NE 125TH Street
Suite 300
North Miami, FL 33161-5833
Phone (786) 221-1734

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · Clinical Medical Laboratory in Colorado

Sources for this page

Verify at the official NPI Registry.