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General NPI Number Information
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NPI Number | 1417912635
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Entity Type | Individual
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Provider Name | FREDERICK JAMES HURLBUT JR. OD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1573 S COLORADO BLVD
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City | DENVER
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State | CO
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Zip | 80222-3704
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Country | US
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Telephone | 303-782-0470
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Fax | 303-782-0474
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Provider Business Mailing Address
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Address Line | 942 S COVE WAY
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City | DENVER
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State | CO
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Zip | 80209-5110
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Country | US
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Telephone | 303-744-6264
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Fax | 303-765-0429
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1069
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License Number State | CO
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