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General NPI Number Information
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NPI Number | 1386116168
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Entity Type | Organization
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Legal Business Name | INFOCUS EYE CARE, PLLC
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 1234 E WOODMEN RD UNIT 120
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-8248
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Country | US
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Telephone | 303-642-6168
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Fax |
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Provider Business Mailing Address
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Address Line | 6609 SHADOW STAR DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80927-4401
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Country | US
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Telephone | 303-642-6168
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JASON RYAN LEONHARDT
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Credential | OD
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Telephone | 303-642-6168
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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 |
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License Number State |
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