Provider Demographics
NPI:1053422352
Name:MARK TALMAGE, M.D., P.C.
Entity type:Organization
Organization Name:MARK TALMAGE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:TALMAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-877-7239
Mailing Address - Street 1:PO BOX 3728
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80161-3728
Mailing Address - Country:US
Mailing Address - Phone:303-877-7239
Mailing Address - Fax:866-271-0712
Practice Address - Street 1:23505 COUNTY ROAD Y
Practice Address - Street 2:
Practice Address - City:VONA
Practice Address - State:CO
Practice Address - Zip Code:80861
Practice Address - Country:US
Practice Address - Phone:303-877-7239
Practice Address - Fax:720-920-9791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27631207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CL5008Medicare ID - Type Unspecified