Healthcare Provider Details

I. General information

NPI: 1679596605
Provider Name (Legal Business Name): THOMAS D CAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 W 2ND PL STE 450
LAKEWOOD CO
80228-1719
US

IV. Provider business mailing address

11700 W 2ND PL STE 450
LAKEWOOD CO
80228-1719
US

V. Phone/Fax

Practice location:
  • Phone: 303-825-1234
  • Fax: 720-321-8121
Mailing address:
  • Phone: 303-825-1234
  • Fax: 720-321-8121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number34575
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: