Physician Compare National (NPI:1720114986)

HEALTHCARE PROVIDER: THOMAS BRADFORD DAVIDSON PSYD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1720114986
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688977192
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160115001777
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAVIDSON
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1978
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6059 S QUEBEC ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 201
	Group Practice or individual's line 2 address
City	GREENWOOD VILLAGE
	Group Practice or individual's city
State	CO
	Group Practice or individual's state
Zip Code	801114523
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3037968451
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y