Todd Dextradeur Md Pc | |
51 W. 84th Ave Ste 300 Thornton CO 80260-4883 | |
(720) 289-8184 | |
(303) 457-2341 |
Full Name | Todd Dextradeur Md Pc |
---|---|
Speciality | Internal Medicine |
Location | 51 W. 84th Ave, Thornton, Colorado |
Authorized Official Name and Position | Todd C. Dextradeur (OWNER/PHYSICIAN) |
Authorized Official Contact | 7202898184 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Todd Dextradeur Md Pc 1324 S. Race Street Denver CO 80210-2332 Ph: (720) 289-8184 | Todd Dextradeur Md Pc 51 W. 84th Ave Ste 300 Thornton CO 80260-4883 Ph: (720) 289-8184 |
NPI Number | 1881864072 |
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Provider Enumeration Date | 03/04/2008 |
Last Update Date | 10/09/2020 |
Medicare PECOS PAC ID | 9335037183 |
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Medicare Enrollment ID | O20040304001151 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881864072 | NPI | - | NPPES |
35500 | Other | CO | MEDICAL LIC |
01355007 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207RS0012X | Internal Medicine - Sleep Medicine | 35500 (Colorado) | Secondary |
Provider Name | Todd C Dextradeur |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801845532 PECOS PAC ID: 7113815978 Enrollment ID: I20090709000121 |
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Alpine Medical Group Colorado Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3655 E 104th Ave Unit A, Thornton, CO 80233 Phone: 303-254-8500 Fax: 303-453-4994 | |
Philip M Henbest Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9981 N Washington St, Suite 21, Thornton, CO 80229 Phone: 303-252-0488 Fax: 303-252-1624 | |
Douthit Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9981 N Washington St, Thornton, CO 80229 Phone: 303-451-8069 Fax: 303-450-2372 |