MEDICARE: DANIEL ALAN THIMSEN M.D.

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	174400000X	Specialist	36386	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

General Provider Information

NPI Number	:	1699854653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL ALAN THIMSEN M.D.

Provider Business Mailing Address
First Line	:	877 CANYON CREEK DR
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-9732
Country	:	US
Telephone Number	:	970-947-1156
Fax Number	:	970-945-9138

Provider Business Practice Location Address
First Line	:	1830 BLAKE AVE
Second Line	:	SUITE 207
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-4275
Country	:	US
Telephone Number	:	970-945-1144
Fax Number	:	970-945-9138

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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