Healthcare Provider Details

I. General information

NPI: 1295482388
Provider Name (Legal Business Name): THOMAS GERHARD PELKMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 PINION DR # 80840
USAF ACADEMY CO
80840-2502
US

IV. Provider business mailing address

4102 PINION DR # 80840
USAF ACADEMY CO
80840-2502
US

V. Phone/Fax

Practice location:
  • Phone: 719-524-2273
  • Fax:
Mailing address:
  • Phone: 719-524-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number36230
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: