Most Relevant Information
Provider Data
| NPI Number: | 1003344862 |
| Provider Name: | ALYSON ANNE THEDE MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207ND0101X |
| Specialty: | Dermatology |
| License Number: | 12229855-1205 |
Most Important Dates
| Enumeration Date: | 05/24/2017 |
| Last Updated: | 02/20/2023 |
Provider Practice Location
815 N 5TH AVE UNIT 202
BOZEMAN
MT
597152884
Practice Location Phone/Fax
| Phone: | 4065452555 |
| Fax: | 4065452554 |
Provider Mailing Location
7300 RANCH ROAD 2222, BUILDING 1, STE 200
AUSTIN
TX
78730
Provider Mailing Phone/Fax
| Phone: | 5126280465 |
| Fax: | 5122332711 |