MEDICARE: TIMO M QUICKERT 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
1	2085R0204X	Vascular & Interventional Radiology Physician	45587	CO

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	:	1982691440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMO M QUICKERT M.D.

Provider Business Mailing Address
First Line	:	4848 THOMPSON PKWY
Second Line	:	SUITE 300
City	:	JOHNSTOWN
State	:	CO
Zip	:	80534-6433
Country	:	US
Telephone Number	:	970-800-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	4848 THOMPSON PKWY
Second Line	:	SUITE 300
City	:	JOHNSTOWN
State	:	CO
Zip	:	80534-6433
Country	:	US
Telephone Number	:	970-800-4145
Fax Number	:

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	12/18/2018

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Directions to “ TIMO M QUICKERT M.D.” Practice Location

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