Provider Demographics
NPI:1073708657
Name:MELISSA T HOCATE MD PC
Entity Type:Organization
Organization Name:MELISSA T HOCATE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HOCATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-475-9613
Mailing Address - Street 1:215 PARKSIDE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910
Mailing Address - Country:US
Mailing Address - Phone:719-475-9613
Mailing Address - Fax:719-475-9539
Practice Address - Street 1:215 PARKSIDE DR
Practice Address - Street 2:STE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910
Practice Address - Country:US
Practice Address - Phone:719-475-9613
Practice Address - Fax:719-475-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41734207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H52398Medicare UPIN
C505128Medicare PIN