Provider Demographics
NPI:1396944880
Name:TICOR MEDICAL PC
Entity type:Organization
Organization Name:TICOR MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:RIBOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-493-1928
Mailing Address - Street 1:14100 E ARAPAHOE RD
Mailing Address - Street 2:STE 390
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4028
Mailing Address - Country:US
Mailing Address - Phone:303-493-1928
Mailing Address - Fax:393-493-1927
Practice Address - Street 1:14100 E ARAPAHOE RD
Practice Address - Street 2:STE 390
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4028
Practice Address - Country:US
Practice Address - Phone:303-493-1928
Practice Address - Fax:393-493-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty