Basic Information
| Provider Information | |||||||||
| NPI: | 1700863578 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAY | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 110429 | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800420429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034937000 | ||||||||
| FaxNumber: | 3034937202 | ||||||||
| Practice Location | |||||||||
| Address1: | 13123 E 16TH AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800457106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7207771234 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2005 | ||||||||
| LastUpdateDate: | 11/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085P0229X | DR.0028927 | CO | Y | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology | 2085R0202X | 28927 | CO | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 2964494 | 05 | IA | MEDICAID | 114695201 | 05 | MI | MEDICAID | 372350 | 05 | AZ | MEDICAID | 8125478 | 05 | WA | MEDICAID | 805473000 | 05 | ID | MEDICAID | V1873 | 05 | NM | MEDICAID | 100177370A | 05 | OK | MEDICAID | 01289271 | 05 | CO | MEDICAID | 100234210C | 05 | KS | MEDICAID | 102958400 | 05 | WY | MEDICAID | 1700863578 | 05 | MT | MEDICAID | XPY203904 | 05 | CA | MEDICAID |