Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G84936 | CO |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | G84936 | CO |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 36995 | CO |
N | 207XX0801X | Orthopaedic Trauma Surgeon | G84936 | CO |
NPI | 1487659918 |
---|---|
Provider Name | Thomas J Noonan |
First Address | Greenwood Village, CO 80111-2803 |
Second Address | Greenwood Village, CO 80111-2808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 09/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G84936 | (02) | |
NO654918 | BCBS (01) | CO |