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General NPI Number Information
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NPI Number | 1578277968
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Entity Type | Organization
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Legal Business Name | BOONDOCTOR LLC
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 965 N TEN MILE DR UNIT A1
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City | FRISCO
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State | CO
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Zip | 80443-5719
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Country | US
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Telephone | 970-401-0962
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Fax | 866-304-9224
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Provider Business Mailing Address
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Address Line | PO BOX 21150
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City | BOULDER
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State | CO
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Zip | 80308-4150
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Country | US
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Telephone | 877-546-9158
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Fax | 877-546-9107
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | AMY L.D. TOMLINSON
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Credential | MD
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Telephone | 970-274-1102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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