Healthcare Provider Details

I. General information

NPI: 1972426856
Provider Name (Legal Business Name): THOMAS JAMES EZRA MCALONAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA J MCALONAN

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4856 INNOVATION DR
FORT COLLINS CO
80525-5539
US

IV. Provider business mailing address

4856 INNOVATION DR
FORT COLLINS CO
80525-5539
US

V. Phone/Fax

Practice location:
  • Phone: 970-494-4200
  • Fax: 844-270-1824
Mailing address:
  • Phone: 970-494-4200
  • Fax: 844-270-1824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: