Healthcare Provider Details

I. General information

NPI: 1174505952
Provider Name (Legal Business Name): PAUL ANDERSON THOMBS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 E 19TH AVE
DENVER CO
80218-1235
US

IV. Provider business mailing address

1719 E 19TH AVE
DENVER CO
80218-1235
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-6900
  • Fax: 303-839-6157
Mailing address:
  • Phone: 303-839-6900
  • Fax: 303-839-6157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number28864
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number28864
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: