Basic Information
| Provider Information | |||||||||
| NPI: | 1609850056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAZIK | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5890 W 13TH ST | ||||||||
| Address2: | STE 101 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806344821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703480020 | ||||||||
| FaxNumber: | 9703480044 | ||||||||
| Practice Location | |||||||||
| Address1: | 5890 W 13TH ST | ||||||||
| Address2: | STE 101 | ||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806344821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703480020 | ||||||||
| FaxNumber: | 9703480044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2005 | ||||||||
| LastUpdateDate: | 11/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 34081 | CO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | PA38719 | 01 | CO | BLUE CROSS BLUE SHIELD | OTHER | 01340819 | 05 | CO | MEDICAID | P00059087 | 01 | RAILROAD MEDICARE | OTHER | 105773800 | 01 | DEPARTMENT OF LABOR | OTHER |