Provider Demographics
NPI:1427002724
Name:BARTLETT, THOMAS J (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:J
Other - Last Name:BARTLETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2 S CASCADE AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1604
Mailing Address - Country:US
Mailing Address - Phone:719-538-2950
Mailing Address - Fax:719-538-2999
Practice Address - Street 1:2222 N NEVADA AVE STE 4001
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6832
Practice Address - Country:US
Practice Address - Phone:719-636-9393
Practice Address - Fax:719-636-9087
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36293207R00000X
CODR.0036293208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP01354513OtherRAIL ROAD MEDICARE
CO01362938Medicaid
CO01362938Medicaid
COG24304Medicare UPIN
CO347719YL2GMedicare PIN