Healthcare Provider Details

I. General information

NPI: 1790828242
Provider Name (Legal Business Name): THOMAS G PHILIPSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 W ALAMEDA AVE
LAKEWOOD CO
80226-3007
US

IV. Provider business mailing address

8383 W ALAMEDA AVE
LAKEWOOD CO
80226-3007
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone: 303-338-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number23056
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: