Provider Demographics
NPI:1801862883
Name:HADDUCK, THOMAS HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HOWARD
Last Name:HADDUCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3701 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3611
Mailing Address - Country:US
Mailing Address - Phone:303-360-6276
Mailing Address - Fax:303-467-5355
Practice Address - Street 1:1666 ELMIRA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-2122
Practice Address - Country:US
Practice Address - Phone:303-340-0415
Practice Address - Fax:303-340-7824
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2016-08-03
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Provider Licenses
StateLicense IDTaxonomies
CODR.0019406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D23603Medicare UPIN