Basic Information
| Provider Information | |||||||||
| NPI: | 1184608531 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THOMAS J PAZIK MD LLC | ||||||||
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| OtherOrganizationName: | COLORADO KNEE AND SHOULDER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6801 W 20TH ST | ||||||||
| Address2: | STE 201 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806349637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703301090 | ||||||||
| FaxNumber: | 9703302925 | ||||||||
| Practice Location | |||||||||
| Address1: | 6801 W 20TH ST | ||||||||
| Address2: | STE 201 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806349637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703301090 | ||||||||
| FaxNumber: | 9703302925 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2005 | ||||||||
| LastUpdateDate: | 03/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | PAZIK | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9703301090 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 34081 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | DA4434 | 01 | RAILROAD MEDICARE | OTHER | 93802820 | 05 | CO | MEDICAID | TH664537 | 01 | CO | BCBS | OTHER |