Organization
PARKSIDE CT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. THOMAS CREPPS M.D. (M.D./MEMBER)
(719) 477-1033
Entity
Organization
Contact information
Practice address
215 PARKSIDE DR, COLORADO SPRINGS, CO 80910-3135
(719) 477-1033
(719) 477-1037
Mailing address
215 PARKSIDE DR, COLORADO SPRINGS, CO 80910-3135
(719) 477-1033
(719) 477-1037
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
31124
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31124
PHYSICIAN LICENSE
CO
Enumeration date
05/18/2006
Last updated
08/22/2020
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