Provider Demographics
NPI:1326086596
Name:MORDICK, THOMAS G II (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:MORDICK
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2058 CLERMONT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3738
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1830 FRANKLIN ST
Practice Address - Street 2:SUITE 450
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1128
Practice Address - Country:US
Practice Address - Phone:303-321-1333
Practice Address - Fax:303-321-0620
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30767207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04013215Medicaid
CO01306760Medicaid
COCR6608Medicare PIN
COCOA100601Medicare PIN