Healthcare Provider Details

I. General information

NPI: 1831572965
Provider Name (Legal Business Name): NATE PATRICK AIGNER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 N ACADEMY BLVD
COLORADO SPRINGS CO
80909-6605
US

IV. Provider business mailing address

320 E FONTANERO ST STE 201
COLORADO SPRINGS CO
80907-7525
US

V. Phone/Fax

Practice location:
  • Phone: 719-559-2020
  • Fax: 719-632-6088
Mailing address:
  • Phone: 719-559-2020
  • Fax: 719-632-6088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number078289
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0003758
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: