Healthcare Provider Details

I. General information

NPI: 1285770651
Provider Name (Legal Business Name): THOMAS S BRASSFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SCOTT BRASSFIELD M.D.

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 N ACADEMY BLVD 5
COLORADO SPRINGS CO
80917-5115
US

IV. Provider business mailing address

3220 N ACADEMY BLVD 5
COLORADO SPRINGS CO
80917-5115
US

V. Phone/Fax

Practice location:
  • Phone: 719-574-3600
  • Fax: 719-574-1686
Mailing address:
  • Phone: 719-574-3600
  • Fax: 719-574-1686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberCO22644
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberCO22644
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License NumberCO22644
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberCO22644
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCO22644
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: