Theobald, Todd A

Theobald, Todd A is an individual health care provider with primary practice located at 280 Exempla Cir , Lafayette CO 80026-3370. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Theobald, Todd A can be contacted via phone (303) 338-4545.

Contact Information

Primary practice address
280 Exempla Cir Lafayette CO 80026-3370
Phone: (303) 338-4545
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 2009032081 Missouri
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101237885 Virginia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 74395 Georgia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X DR.0057386 Colorado

Profile Details

NPI number 1720077993
LBN Legal business name Theobald, Todd A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2005
Last updated Jun 21st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720077993 NPPES
Other 431560263 TRICARE WEST
Other 027564 TRICARE WEST
MEDICAID 04155149 TRICARE WEST
Other P00799494 TRICARE WEST

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