Provider Demographics
NPI:1063522423
Name:HEFFRON, THOMAS G (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:HEFFRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8490 E CRESCENT PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2815
Mailing Address - Country:US
Mailing Address - Phone:303-957-1310
Mailing Address - Fax:303-761-4252
Practice Address - Street 1:2535 S DOWNING ST STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5851
Practice Address - Country:US
Practice Address - Phone:303-777-7112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47369208600000X, 204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91171009Medicaid
CO304758Medicare PIN
CO91171009Medicaid