Provider Demographics
NPI:1194907592
Name:TORGENSON, MARCUS JEWELL (MD)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:JEWELL
Last Name:TORGENSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1599
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83816-1599
Mailing Address - Country:US
Mailing Address - Phone:208-625-5200
Mailing Address - Fax:208-625-5201
Practice Address - Street 1:700 W IRONWOOD DR STE 341
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4404
Practice Address - Country:US
Practice Address - Phone:208-625-5200
Practice Address - Fax:208-625-5201
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5761523-1205208600000X
IDM-10728208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0251161OtherWA L&I
ID1196087OtherCIGNA MEDICARE
IDP00766399OtherRAILROAD MEDICARE
ID000010173473OtherREGENCE BLUE SHIELD
ID77947OtherBLUE CROSS