Provider Demographics
NPI:1023001948
Name:WORKMAN, FREDERICK M (DO)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:M
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 S CASCADE AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1624
Mailing Address - Country:US
Mailing Address - Phone:719-538-2900
Mailing Address - Fax:719-538-2961
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-636-9393
Practice Address - Fax:719-538-2961
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006839207R00000X
CO46235207RS0010X
IN02005118A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO26133059Medicaid
COC811932Medicare PIN
CO694249Medicare UPIN
OH000000210235OtherANTHEM
OH110231602OtherRRMC
OH7970229OtherAETNA
CO26133059Medicaid
CO694249Medicare UPIN
COC811932Medicare PIN
OH2177906Medicaid
OH03978OtherPHC