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General NPI Number Information
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NPI Number | 1669442224
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Entity Type | Individual
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Provider Name | MARTI RUE DAVIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 1860 E EGBERT ST
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City | BRIGHTON
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State | CO
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Zip | 80601-2475
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Country | US
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Telephone | 303-659-4000
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Fax | 303-655-4924
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Provider Business Mailing Address
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Address Line | 203 S ROLLIE AVE BILLING DEPT - CREDENTIALIST
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City | FORT LUPTON
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State | CO
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Zip | 80621-1508
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Country | US
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Telephone | 303-286-4560
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Fax | 303-286-4589
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0427008
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0427008
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0056041
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License Number State | CO
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