Provider Demographics
NPI:1194933614
Name:MARTIN, REBEKAH LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:LEIGH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1710 JET STREAM DR STE 110
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3937
Mailing Address - Country:US
Mailing Address - Phone:719-282-7850
Mailing Address - Fax:719-457-6200
Practice Address - Street 1:1710 JET STREAM DR STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3937
Practice Address - Country:US
Practice Address - Phone:719-282-7850
Practice Address - Fax:719-457-6200
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.122409208100000X
CODR.0048826208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation