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General NPI Number Information
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NPI Number | 1043638471
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Entity Type | Organization
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Legal Business Name | HIGH PLAINS EYE CARE INC
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 1300 BARLOW RD INSIDE WALMART VISION CENTER
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City | FORT MORGAN
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State | CO
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Zip | 80701-4363
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Country | US
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Telephone | 970-542-2291
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Fax | 970-542-2294
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Provider Business Mailing Address
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Address Line | PO BOX 254
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City | FORT MORGAN
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State | CO
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Zip | 80701-0254
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Country | US
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Telephone | 970-542-2291
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Fax | 970-542-2294
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID S HITE
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Credential | O.D.
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Telephone | 801-319-5866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0002982
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License Number State | CO
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