MEDICARE: ALICIA RUTH APPLE DO

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	207P00000X	Emergency Medicine Physician	1730441783	OK
2	208000000X	Pediatrics Physician	DR.0059934	CO

General Provider Information

NPI Number	:	1730441783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA RUTH APPLE DO

Provider Business Mailing Address
First Line	:	4190 E WOODMEN RD STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-8075
Country	:	US
Telephone Number	:	719-632-4455
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 PRO RODEO DR STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-2334
Country	:	US
Telephone Number	:	719-522-0707
Fax Number	:

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

Provider Enumeration Date	:	06/14/2012
Last Update Date	:	12/30/2020

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Directions to “ ALICIA RUTH APPLE DO” Practice Location

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