Provider Demographics
NPI:1740718998
Name:DAVID THEIS, D.O., P.C.
Entity type:Organization
Organization Name:DAVID THEIS, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:THEIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:740-317-9272
Mailing Address - Street 1:595 CHAPEL HILLS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1056
Mailing Address - Country:US
Mailing Address - Phone:719-475-9613
Mailing Address - Fax:719-475-9539
Practice Address - Street 1:595 CHAPEL HILLS DR STE 201
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1056
Practice Address - Country:US
Practice Address - Phone:719-475-9613
Practice Address - Fax:719-475-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS017698207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty