Martin, Dale R

Martin, Dale R is an individual health care provider with primary practice located at 2500 E Prospect Rd , Fort Collins CO 80525-9718. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Martin, Dale R can be contacted via phone (970) 493-0112.

Contact Information

Primary practice address
2500 E Prospect Rd Fort Collins CO 80525-9718
Phone: (970) 493-0112
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X DR.0032028 Colorado

Profile Details

NPI number 1871576140
LBN Legal business name Martin, Dale R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated Dec 16th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871576140 NPPES
Colorado MEDICAID 01320282
Colorado MEDICAID 109798900

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