Individual
DR. JERRY E MARKUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Mailing address
200 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
42097
CO
208M00000X
Hospitalist Physician
Primary
42097
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015171
KAISER-COMMERCIAL NUMBER
—
05
—
89337760
—
CO
Enumeration date
02/27/2007
Last updated
09/28/2012
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