Basic Information
Provider Information
NPI: 1629072228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEGGS
FirstName: MARTIN
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: M.D.
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Mailing Information
Address1: 2695 ROCKY MOUNTAIN AVE
Address2: SUITE 150
City: LOVELAND
State: CO
PostalCode: 805388702
CountryCode: US
TelephoneNumber: 9706244443
FaxNumber: 9704904175
Practice Location
Address1: 525 N FOOTE AVE
Address2: STE 302
City: COLORADO SPRINGS
State: CO
PostalCode: 809094501
CountryCode: US
TelephoneNumber: 7193655445
FaxNumber: 7193655530
Other Information
ProviderEnumerationDate: 06/10/2005
LastUpdateDate: 02/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000X49106COY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

ID Information
IDTypeStateIssuerDescription
9397932105CO MEDICAID


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