Provider Demographics
NPI:1336178664
Name:MURTHY, KRISHNA C (MD)
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:C
Last Name:MURTHY
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:PO BOX 1995
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776-1995
Mailing Address - Country:US
Mailing Address - Phone:828-575-2644
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:SUITE 350
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-221-2370
Practice Address - Fax:970-221-9654
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23093207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01230937Medicaid
CO391628ZMHCOtherMEDICARE PTAN
WYW27147OtherMEDICARE PTAN
CO391628ZMHCOtherMEDICARE PTAN