Provider Demographics
NPI:1578277968
Name:BOONDOCTOR LLC
Entity Type:Organization
Organization Name:BOONDOCTOR LLC
Other - Org Name:DR. AMY TOMLINSON GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LD
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-274-1102
Mailing Address - Street 1:PO BOX 21150
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80308-4150
Mailing Address - Country:US
Mailing Address - Phone:877-546-9158
Mailing Address - Fax:877-546-9107
Practice Address - Street 1:965 N TEN MILE DR UNIT A1
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-5719
Practice Address - Country:US
Practice Address - Phone:970-401-0962
Practice Address - Fax:866-304-9224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty