Provider Demographics
NPI:1447247242
Name:HAYGOOD, THOMAS ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ARTHUR
Last Name:HAYGOOD
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 1:1600 SPECHT POINT RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:FT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4311
Mailing Address - Country:US
Mailing Address - Phone:970-493-7733
Mailing Address - Fax:970-493-8745
Practice Address - Street 1:1600 SPECHT POINT RD
Practice Address - Street 2:SUITE I
Practice Address - City:FT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4311
Practice Address - Country:US
Practice Address - Phone:970-493-7733
Practice Address - Fax:970-493-8745
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23022207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01230226Medicaid
COJ5038Medicare ID - Type Unspecified
COA88854Medicare UPIN