Provider Demographics
NPI:1083889927
Name:MANCHESTER, THOMAS L (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:MANCHESTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1000 LINCOLN ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3290
Mailing Address - Country:US
Mailing Address - Phone:970-542-4371
Mailing Address - Fax:970-542-4373
Practice Address - Street 1:1000 LINCOLN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3290
Practice Address - Country:US
Practice Address - Phone:970-542-4371
Practice Address - Fax:970-542-4373
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2016-02-29
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Provider Licenses
StateLicense IDTaxonomies
CO49038208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery