Healthcare Provider Details
I. General information
NPI: 1295124071
Provider Name (Legal Business Name): ANDREA TSORIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/15/2015
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2222 N NEVADA AVE STE 5017
COLORADO SPRINGS CO
80907-6865
US
IV. Provider business mailing address
6820 HWY 70 S APT 318
NASHVILLE TN
37221-5237
US
V. Phone/Fax
- Phone: 719-776-6810
- Fax: 719-776-6820
- Phone: 224-217-8235
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | DR.0068541 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | LP03741 |
| License Number State | RI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: