Healthcare Provider Details

I. General information

NPI: 1588676324
Provider Name (Legal Business Name): THOMAS C ATWOOD DPM,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 9TH ST SUITE 3
GREELEY CO
80631-3089
US

IV. Provider business mailing address

2122 9TH ST SUITE 3
GREELEY CO
80631-3089
US

V. Phone/Fax

Practice location:
  • Phone: 970-353-5800
  • Fax: 970-353-5854
Mailing address:
  • Phone: 970-353-5800
  • Fax: 970-353-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number457
License Number StateCO

VIII. Authorized Official

Name: DR. THOMAS CLYDE ATWOOD
Title or Position: PRESIDENT
Credential: DPM
Phone: 970-353-5800