Provider Demographics
NPI:1235110602
Name:DOFT, ANTHONY A (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:A
Last Name:DOFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4209
Mailing Address - Country:US
Mailing Address - Phone:970-663-0135
Mailing Address - Fax:970-461-1422
Practice Address - Street 1:8201 SPINNAKER BAY DR
Practice Address - Street 2:SUITE D
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80528-7533
Practice Address - Country:US
Practice Address - Phone:970-223-2272
Practice Address - Fax:970-223-1304
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38227207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36876259Medicaid
CODO635462OtherANTHEM BCBS
NE$$$$$$$$$Medicaid
CO36876259Medicaid
CODO635462OtherANTHEM BCBS
CO080153369Medicare PIN