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General NPI Number Information
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NPI Number | 1730165911
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Entity Type | Individual
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Provider Name | ELLEN R BLATT M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 10101 RIDGEGATE PKWY
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City | LONE TREE
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State | CO
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Zip | 80124-5522
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Country | US
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Telephone | 303-761-9190
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Fax | 303-761-6278
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Provider Business Mailing Address
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Address Line | 10700 E GEDDES AVE SUITE 200
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City | ENGLEWOOD
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State | CO
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Zip | 80112-3800
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Country | US
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Telephone | 303-761-9190
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Fax | 303-761-6278
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 43492
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 24976
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 04-36346
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD17582
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License Number State | HI
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