Individual
THOMAS JACOB CORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 BOISE AVE, LOVELAND, CO 80538-5006
(970) 635-4071
(970) 635-4177
Mailing address
PO BOX 173817, DENVER, CO 80217-3817
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
047701
CT
207P00000X
Emergency Medicine Physician
48063
CO
208D00000X
General Practice Physician
Primary
047701
CT
208D00000X
General Practice Physician
48063
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021193
KAISER COMMERCIAL NUMBER
CO
05
—
86452550
—
CO
Enumeration date
08/16/2007
Last updated
07/29/2024
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