Provider Demographics
NPI:1295798171
Name:ESKESTRAND, THOMAS A (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:ESKESTRAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7206
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80933-7206
Mailing Address - Country:US
Mailing Address - Phone:719-471-1101
Mailing Address - Fax:719-471-9637
Practice Address - Street 1:160 W FILLMORE ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6155
Practice Address - Country:US
Practice Address - Phone:719-471-1101
Practice Address - Fax:719-471-9637
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26345207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01263458Medicaid
COCO304292Medicare PIN
COC28791Medicare PIN