Provider Demographics
NPI:1699744367
Name:STORHEIM, JOHN ENGH JR (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ENGH
Last Name:STORHEIM
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:STORHEIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1120 WELLINGTON AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6131
Mailing Address - Country:US
Mailing Address - Phone:970-243-7245
Mailing Address - Fax:
Practice Address - Street 1:2635 N 7TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8209
Practice Address - Country:US
Practice Address - Phone:970-244-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230386207L00000X, 207LP2900X
UT4772460-1204207L00000X, 207LP2900X
CO47789207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21727932Medicaid
COCO305130Medicare PIN