Basic Information
| Provider Information | |||||||||
| NPI: | 1447230339 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL J TUOHY MD & ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2171 | ||||||||
| Address2: | |||||||||
| City: | GLENWOOD SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816022171 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709451443 | ||||||||
| FaxNumber: | 9709479410 | ||||||||
| Practice Location | |||||||||
| Address1: | 1906 BLAKE AVE | ||||||||
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| City: | GLENWOOD SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816014227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709456535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | TUOHY | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT ANESTHESIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 9709456535 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 01320001 | 05 | CO | MEDICAID |