Provider Demographics
NPI:1568686590
Name:THOMAS C. RIBOVICH, MD PC
Entity type:Organization
Organization Name:THOMAS C. RIBOVICH, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:RIBOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-493-1928
Mailing Address - Street 1:14100 E ARAPAHOE RD STE 390
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4048
Mailing Address - Country:US
Mailing Address - Phone:303-493-1928
Mailing Address - Fax:303-493-1927
Practice Address - Street 1:14100 E ARAPAHOE RD STE 390
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4048
Practice Address - Country:US
Practice Address - Phone:303-493-1928
Practice Address - Fax:303-493-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29656207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO800525Medicare ID - Type Unspecified
COC98054Medicare UPIN