Provider Demographics
NPI:1548266240
Name:WHITE, THOMAS C (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:C
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PC
Mailing Address - Street 1:200 W COUNTY LINE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2342
Mailing Address - Country:US
Mailing Address - Phone:303-996-2800
Mailing Address - Fax:303-470-9595
Practice Address - Street 1:200 W COUNTY LINE RD STE 100
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2342
Practice Address - Country:US
Practice Address - Phone:303-996-2800
Practice Address - Fax:303-470-9595
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22583207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODE3692OtherRAILROAD MEDICARE
CO46820078Medicaid
CO46820078Medicaid
CODE3692OtherRAILROAD MEDICARE