Provider Demographics
NPI:1992168447
Name:THOMAS, AKIVA M (DO)
Entity type:Individual
Prefix:DR
First Name:AKIVA
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-1603
Mailing Address - Country:US
Mailing Address - Phone:303-900-2631
Mailing Address - Fax:303-600-0281
Practice Address - Street 1:5 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-1603
Practice Address - Country:US
Practice Address - Phone:303-900-2631
Practice Address - Fax:303-600-0281
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0059075208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice