Healthcare Provider Details

I. General information

NPI: 1992168447
Provider Name (Legal Business Name): AKIVA M THOMAS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 S 1ST AVE
BRIGHTON CO
80601-1603
US

IV. Provider business mailing address

5 S 1ST AVE
BRIGHTON CO
80601-1603
US

V. Phone/Fax

Practice location:
  • Phone: 303-900-2631
  • Fax: 303-600-0281
Mailing address:
  • Phone: 303-900-2631
  • Fax: 303-600-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number5101027200
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0059075
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: