Provider Demographics
NPI:1104365451
Name:MARTIN J VERHEY M.D. LLC
Entity Type:Organization
Organization Name:MARTIN J VERHEY M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:VERHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-576-8310
Mailing Address - Street 1:380 PAISLEY DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-8251
Mailing Address - Country:US
Mailing Address - Phone:719-576-8310
Mailing Address - Fax:
Practice Address - Street 1:380 PAISLEY DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-8251
Practice Address - Country:US
Practice Address - Phone:719-576-8310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0040153207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO015727572Medicaid
COC454748Medicare PIN
COB09008Medicare UPIN