Healthcare Provider Details
I. General information
NPI: 1245497452
Provider Name (Legal Business Name): JOHN L SCHACHET OD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2008
Last Update Date: 03/30/2012
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
- Phone: 303-771-4221
- Fax:
- Phone: 303-771-4221
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | 825 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
JOHN
L
SCHACHET
Title or Position: OWNER/PRESIDENT
Credential: OD
Phone: 303-771-4221