Provider Demographics
NPI:1790998938
Name:DAVID M. MORFORD, DPM, LLC
Entity Type:Organization
Organization Name:DAVID M. MORFORD, DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:719-272-3818
Mailing Address - Street 1:PO BOX 49663
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80949-9663
Mailing Address - Country:US
Mailing Address - Phone:719-272-3818
Mailing Address - Fax:719-531-5399
Practice Address - Street 1:1910 VINDICATOR DR
Practice Address - Street 2:SUITE 102
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3623
Practice Address - Country:US
Practice Address - Phone:719-272-3818
Practice Address - Fax:719-531-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPOD 601213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82129231Medicaid
COC448588Medicare PIN
COC448588Medicare ID - Type Unspecified
CO82129231Medicaid