Provider Demographics
NPI:1750775102
Name:LESAVOY, MELISSA MARIE (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:LESAVOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2720
Mailing Address - Country:US
Mailing Address - Phone:719-543-6755
Mailing Address - Fax:719-583-2236
Practice Address - Street 1:20 AUDUBON CIR
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3901
Practice Address - Country:US
Practice Address - Phone:203-535-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT211455207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology