Provider Demographics
NPI:1144357724
Name:HAMNER, MARSHA H (MD)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:H
Last Name:HAMNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:H
Other - Last Name:TALLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3403 MUSKRAT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-7028
Mailing Address - Country:US
Mailing Address - Phone:970-302-5879
Mailing Address - Fax:
Practice Address - Street 1:1801 16TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5154
Practice Address - Country:US
Practice Address - Phone:970-810-4733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39783207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO305207Medicare PIN
COC808671Medicare PIN