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General NPI Number Information
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NPI Number | 1477995454
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Entity Type | Individual
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Provider Name | CAMILLE STEPHANIE MELLIJOR-FIGG M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 430 S CACHE ST
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City | JACKSON
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State | WY
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Zip | 83001-8692
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Country | US
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Telephone | 307-201-1489
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Fax |
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Provider Business Mailing Address
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Address Line | 480 S CACHE ST PO BOX 12740
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City | JACKSON
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State | WY
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Zip | 83001
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Country | US
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Telephone | 307-201-1489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MC-1555
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 11150A
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License Number State | WY
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