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NPI Code Detail

MEDICARE: MARK C MEYER MD LLC

MEDICARE: MARK C MEYER MD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine Physician
2207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110403617OTHERCOCAQH PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
335250OTHERCOCOLORADO LICENSE

General Provider Information

NPI Number : 1821175100
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK C MEYER MD LLC
Provider Business Mailing Address
First Line : 5901 CORPORATE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1941
Country : US
Telephone Number : 719-598-7562
Fax Number : 719-598-2775
Provider Business Practice Location Address
First Line : 5901 CORPORATE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1941
Country : US
Telephone Number : 719-598-7562
Fax Number : 719-598-2775
Authorized Official
Title or Position : MANAGING AGENT
Name : MARK C MEYER
Credential : M.D.
Telephone Number : 719-448-0981
Provider Enumeration Date : 11/01/2006
Last Update Date : 03/07/2023

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Directions to “MARK C MEYER MD LLC ” Practice Location

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