Provider Demographics
NPI:1275690364
Name:MCCROSKEY, THOMAS TAYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:TAYLOR
Last Name:MCCROSKEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3613
Mailing Address - Country:US
Mailing Address - Phone:303-320-1918
Mailing Address - Fax:
Practice Address - Street 1:1169 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-3613
Practice Address - Country:US
Practice Address - Phone:303-320-1918
Practice Address - Fax:303-355-4602
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18363Medicare ID - Type Unspecified