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NPI Code Detail

MEDICARE: STEPHANIE DIANE THOMAS M.D.

MEDICARE: STEPHANIE DIANE THOMAS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician49800CO

General Provider Information

NPI Number : 1740422088
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE DIANE THOMAS M.D.
Provider Business Mailing Address
First Line : 1555 S WADSWORTH BLVD
Second Line :
City : LAKEWOOD
State : CO
Zip : 80232-6832
Country : US
Telephone Number : 303-985-1597
Fax Number :
Provider Business Practice Location Address
First Line : 1555 S WADSWORTH BLVD
Second Line :
City : LAKEWOOD
State : CO
Zip : 80232-6832
Country : US
Telephone Number : 303-985-1597
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2009
Last Update Date : 01/16/2013

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