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Individual

DR. THOMAS MICHAEL ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
43505
CO
246ZC0007X
Surgical Assistant
43505
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
52156338
CO
01
P00855795
RR MEDICARE
CO
Enumeration date
10/21/2005
Last updated
12/16/2019
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