Healthcare Provider Details

I. General information

NPI: 1548254881
Provider Name (Legal Business Name): REPINE VISION AND LASER PROFESSIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8381 SOUTHPARK LN
LITTLETON CO
80120-4508
US

IV. Provider business mailing address

8381 SOUTHPARK LN
LITTLETON CO
80120-4508
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-8848
  • Fax: 303-730-6163
Mailing address:
  • Phone: 303-788-8848
  • Fax: 303-730-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN M REPINE
Title or Position: OWNER
Credential: MD
Phone: 303-788-8848