Healthcare Provider Details

I. General information

NPI: 1326086596
Provider Name (Legal Business Name): THOMAS G MORDICK II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 FRANKLIN ST SUITE 450
DENVER CO
80218-1128
US

IV. Provider business mailing address

2058 CLERMONT ST
DENVER CO
80207-3738
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-1333
  • Fax: 303-321-0620
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number30767
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: