MEDICARE: KELLY CHRISTINA LASKOSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	DR.0068734	CO

General Provider Information

NPI Number	:	1215351176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY CHRISTINA LASKOSKI MD

Provider Business Mailing Address
First Line	:	1975 RESEARCH PKWY STE 165
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1026
Country	:	US
Telephone Number	:	719-574-0310
Fax Number	:	719-574-6574

Provider Business Practice Location Address
First Line	:	1975 RESEARCH PKWY STE 165
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1026
Country	:	US
Telephone Number	:	719-574-0310
Fax Number	:	719-574-6574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	09/23/2025

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