Provider Demographics
NPI:1144407164
Name:MILE HIGH GASTROENTEROLOGY,P.C.
Entity Type:Organization
Organization Name:MILE HIGH GASTROENTEROLOGY,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-861-4500
Mailing Address - Street 1:2005 FRANKLIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5403
Mailing Address - Country:US
Mailing Address - Phone:303-861-4500
Mailing Address - Fax:303-863-1320
Practice Address - Street 1:2005 FRANKLIN ST STE 210
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5403
Practice Address - Country:US
Practice Address - Phone:303-861-4500
Practice Address - Fax:303-863-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21059207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01210590Medicaid
CO04007076Medicaid
CE05725Medicare UPIN
CE8818Medicare PIN