Healthcare Provider Details

I. General information

NPI: 1225114002
Provider Name (Legal Business Name): WILLIAM P BREEN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8586 E ARAPAHOE RD STE 100
CENTENNIAL CO
80112-1433
US

IV. Provider business mailing address

8586 E ARAPAHOE RD STE 100
CENTENNIAL CO
80112-1433
US

V. Phone/Fax

Practice location:
  • Phone: 303-771-4221
  • Fax: 303-721-7759
Mailing address:
  • Phone: 303-771-4221
  • Fax: 303-721-7759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number916
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number916
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number916
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: