Provider Demographics
NPI:1104128339
Name:THOMAS, MATTHEW REED (DPM)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:REED
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 TENDERFOOT HILL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-8356
Mailing Address - Country:US
Mailing Address - Phone:719-867-8838
Mailing Address - Fax:
Practice Address - Street 1:2620 TENDERFOOT HILL ST STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-8356
Practice Address - Country:US
Practice Address - Phone:719-867-8838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPOD.0000727213ES0103X
NV1204213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97005070Medicaid
CO12415184OtherCAQH
COGH1252Medicare UPIN