Boersma, Timothy W
Boersma, Timothy W is an individual health care provider with primary practice located at 175 S Union Blvd Ste 350 , Colorado Springs CO 80910-3146. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Boersma, Timothy W can be contacted via phone (719) 633-5515.Contact Information
Primary practice address
175 S Union Blvd Ste 350
Colorado Springs CO 80910-3146
Phone: (719) 633-5515
Fax: (719) 365-1307
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 036126968 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DR.0061598 | Colorado |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | F3766 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036126968 | Illinois |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | DR.0061598 | Colorado |
Profile Details
| NPI number | 1942244926 |
|---|---|
| LBN Legal business name | Boersma, Timothy W |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Sep 2nd, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942244926 | NPPES |
| Texas | MEDICAID | 113686306 | |
| Texas | MEDICAID | 1136863 | |
| Texas | Other | 75-2616977-066 | |
| Texas | Other | 8DZ891 | |
| Texas | Other | 8F5719 | |
| Texas | MEDICAID | 9000173087 | |
| Texas | MEDICAID | 113686305 | |
| Texas | Other | P01092668 |
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