Provider Demographics
NPI:1124019443
Name:MARCUM, LINDA KAY (OTR)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:MARCUM
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12127 W COOPER DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4861
Mailing Address - Country:US
Mailing Address - Phone:303-437-4364
Mailing Address - Fax:303-223-3462
Practice Address - Street 1:12127 W COOPER DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4861
Practice Address - Country:US
Practice Address - Phone:303-437-4364
Practice Address - Fax:303-223-3462
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100984174400000X
CO2790174400000X
COOT.0002790225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO307166Medicare PIN