Provider Demographics
NPI:1083762306
Name:GAENSBAUER, THEODORE JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:JOHN
Last Name:GAENSBAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3400 E BAYAUD AVE
Mailing Address - Street 2:SUITE 460
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2926
Mailing Address - Country:US
Mailing Address - Phone:303-777-8731
Mailing Address - Fax:303-777-5857
Practice Address - Street 1:3400 E BAYAUD AVE
Practice Address - Street 2:SUITE 460
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2926
Practice Address - Country:US
Practice Address - Phone:303-777-8731
Practice Address - Fax:303-777-5857
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO183402084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry