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General NPI Number Information
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NPI Number | 1861455271
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Entity Type | Individual
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Provider Name | THOMAS M. AQUISTO MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 800 S 3RD ST
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City | MONTROSE
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State | CO
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Zip | 81401-4212
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Country | US
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Telephone | 970-249-2211
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Fax | 847-570-2942
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Provider Business Mailing Address
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Address Line | 2233 E MAIN ST
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City | MONTROSE
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State | CO
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Zip | 81401-3831
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Country | US
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Telephone | 970-765-0831
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Fax | 970-497-8410
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036111038
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD61605753
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 036111038
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 63669
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | DR.0063234
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License Number State | CO
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