Healthcare Provider Details

I. General information

NPI: 1164750022
Provider Name (Legal Business Name): DAVID J OHSIEK O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7863 MULE DEER PL
LITTLETON CO
80125-8870
US

IV. Provider business mailing address

7863 MULE DEER PL
LITTLETON CO
80125-8870
US

V. Phone/Fax

Practice location:
  • Phone: 720-981-0389
  • Fax:
Mailing address:
  • Phone: 720-981-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2075
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: