MEDICARE: THOMAS JEFFREY JUDE THERRIEN D.O.

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
1	207P00000X	Emergency Medicine Physician	A-1785-13	NM
2	207P00000X	Emergency Medicine Physician	02002491A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831284520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS JEFFREY JUDE THERRIEN D.O.

Provider Business Mailing Address
First Line	:	413 WHITNEY HBR
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-6163
Country	:	US
Telephone Number	:	937-545-7091
Fax Number	:

Provider Business Practice Location Address
First Line	:	413 WHITNEY HBR
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-6163
Country	:	US
Telephone Number	:	937-478-5934
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	03/26/2026

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