Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 39672 | CO |
NPI | 1013044023 |
---|---|
Provider Name | Dr. Thomas J Wescom |
First Address | Lafayette, CO 80026-3370 |
Second Address | Lafayette, CO 80026-3370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 27/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
013160 | KAISER-COMMERCIAL NUMBER (01) | |
38780381 | (05) | CO |
H45394 | (02) | CO |