Healthcare Provider Details

I. General information

NPI: 1316280258
Provider Name (Legal Business Name): DOCTORS OPTICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 DELAWARE ST
DENVER CO
80204-4532
US

IV. Provider business mailing address

1685 S COLORADO BLVD UNIT O
DENVER CO
80222-4000
US

V. Phone/Fax

Practice location:
  • Phone: 303-825-2286
  • Fax: 303-825-2418
Mailing address:
  • Phone: 303-757-6747
  • Fax: 303-757-6897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. RUTH BRAD
Title or Position: ADMINISTRATOR
Credential:
Phone: 303-757-6747