Provider Demographics
NPI:1982640637
Name:MARTINCHICK, JAMES F (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:MARTINCHICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8290 SPINNAKER BAY DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80528-7535
Mailing Address - Country:US
Mailing Address - Phone:307-760-9818
Mailing Address - Fax:405-815-3425
Practice Address - Street 1:1040 E ELIZABETH ST STE B
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3952
Practice Address - Country:US
Practice Address - Phone:307-760-9818
Practice Address - Fax:405-815-3425
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0040038207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY114643200Medicaid
WY308140Medicare ID - Type Unspecified