Provider Demographics
NPI:1700907300
Name:TONEY, JUDITH H (DO)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:H
Last Name:TONEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:A
Other - Last Name:HOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:345 MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3972
Mailing Address - Country:US
Mailing Address - Phone:303-544-5783
Mailing Address - Fax:303-441-2388
Practice Address - Street 1:1000 W SOUTH BOULDER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2752
Practice Address - Country:US
Practice Address - Phone:303-666-7555
Practice Address - Fax:303-661-9168
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46187207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO65321502Medicaid
COCOA102625Medicare PIN