MEDICARE: DR. DAVID REID CLAUSEN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	961	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518923341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID REID CLAUSEN O.D.

Provider Business Mailing Address
First Line	:	620 E PHILLIPS DR S
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80122-2869
Country	:	US
Telephone Number	:	303-730-9004
Fax Number	:

Provider Business Practice Location Address
First Line	:	7562 S UNIVERSITY BLVD
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80122-3159
Country	:	US
Telephone Number	:	303-773-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	07/08/2007

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