MEDICARE: DR. THOMAS G MORDICK II MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0106X	Orthopaedic Hand Surgery Physician	30767	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326086596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS G MORDICK II MD

Provider Business Mailing Address
First Line	:	2058 CLERMONT ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80207-3738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1830 FRANKLIN ST
Second Line	:	SUITE 450
City	:	DENVER
State	:	CO
Zip	:	80218-1128
Country	:	US
Telephone Number	:	303-321-1333
Fax Number	:	303-321-0620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	10/10/2023

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