Healthcare Provider Details

I. General information

NPI: 1790998938
Provider Name (Legal Business Name): DAVID M. MORFORD, DPM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 VINDICATOR DR SUITE 102
COLORADO SPRINGS CO
80919-3623
US

IV. Provider business mailing address

PO BOX 49663
COLORADO SPRINGS CO
80949-9663
US

V. Phone/Fax

Practice location:
  • Phone: 719-272-3818
  • Fax: 719-531-5399
Mailing address:
  • Phone: 719-272-3818
  • Fax: 719-531-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPOD 601
License Number StateCO

VIII. Authorized Official

Name: DR. DAVID M. MORFORD
Title or Position: PRESIDENT OWNER
Credential: DPM
Phone: 719-272-3818