Provider Demographics
NPI:1518096023
Name:TOLD, THOMAS N (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:N
Last Name:TOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-3047
Mailing Address - Country:US
Mailing Address - Phone:970-824-3213
Mailing Address - Fax:970-824-6476
Practice Address - Street 1:580 PERSHING ST
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-3047
Practice Address - Country:US
Practice Address - Phone:970-824-3213
Practice Address - Fax:970-824-6476
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0118900Medicaid
CO34058Medicare ID - Type Unspecified
CO0118900Medicaid