Healthcare Provider Details

I. General information

NPI: 1982888525
Provider Name (Legal Business Name): C. EDWARD WILLIAMS, O.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 10/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 MADISON ST SUITE 100
DENVER CO
80206-5434
US

IV. Provider business mailing address

123 MADISON ST SUITE 100
DENVER CO
80206-5434
US

V. Phone/Fax

Practice location:
  • Phone: 303-355-6111
  • Fax: 303-355-0388
Mailing address:
  • Phone: 303-355-6111
  • Fax: 303-355-0388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number1286
License Number StateCO

VIII. Authorized Official

Name: DR. EDWARD P WILLIAMS
Title or Position: DOCTOR
Credential:
Phone: 303-355-6111