Individual
THOMAS G. MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2655 CRESCENT DR, SUITE C, LAFAYETTE, CO 80026-3372
(303) 443-4200
(303) 443-5470
Mailing address
4891 INDEPENDENCE ST, SUITE 120, WHEAT RIDGE, CO 80033-6752
(303) 456-5495
(303) 456-7490
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
35172
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01351725
—
CO
01
—
390005667
RR MEDICARE
CO
Enumeration date
11/04/2005
Last updated
10/20/2008
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