Healthcare Provider Details

I. General information

NPI: 1326016643
Provider Name (Legal Business Name): LLOYD J THURSTON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2006
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 W 26TH AVE BLDG A-300
DENVER CO
80211-5314
US

IV. Provider business mailing address

2490 W 26TH AVE BLDG A-300
DENVER CO
80211-5314
US

V. Phone/Fax

Practice location:
  • Phone: 303-831-9393
  • Fax: 303-831-6335
Mailing address:
  • Phone: 303-831-9393
  • Fax: 303-831-6335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number01783
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: