MEDICARE: THOMAS M FAHRBACH MD

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	2085R0204X	Vascular & Interventional Radiology Physician	DR.0060256	CO
2	2085R0204X	Vascular & Interventional Radiology Physician	004991	GA
3	2085R0202X	Diagnostic Radiology Physician	0435699	KS
4	2085R0202X	Diagnostic Radiology Physician	DR.0060256	CO

General Provider Information

NPI Number	:	1962558577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS M FAHRBACH MD

Provider Business Mailing Address
First Line	:	42 GARDEN CTR
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-1730
Country	:	US
Telephone Number	:	303-465-0401
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	MAIL STOP 4032
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8500
Country	:	US
Telephone Number	:	913-588-6805
Fax Number	:

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	02/13/2026

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