Healthcare Provider Details
I. General information
NPI: 1043329113
Provider Name (Legal Business Name): DENVER EYE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1485 S COLORADO BLVD #220
DENVER CO
80222-3619
US
IV. Provider business mailing address
1485 S COLORADO BLVD #220
DENVER CO
80222-3619
US
V. Phone/Fax
- Phone: 303-839-7878
- Fax: 303-759-9375
- Phone: 303-839-7878
- Fax: 303-759-9375
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
B
GILTNER
Title or Position: OWNER/PRES
Credential: MD
Phone: 303-839-7878