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General NPI Number Information
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NPI Number | 1700275047
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Entity Type | Organization
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Legal Business Name | ELEVATED EYECARE, P.C.
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Dates
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Enumeration Date | 01/09/2015
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 4660 YOSEMITE ST STE 150
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City | DENVER
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State | CO
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Zip | 80238-4482
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Country | US
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Telephone | 303-284-9889
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Fax | 303-284-9914
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Provider Business Mailing Address
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Address Line | 4660 YOSEMITE ST STE 150
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City | DENVER
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State | CO
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Zip | 80238-4482
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Country | US
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Telephone | 303-284-9889
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Fax | 303-284-9889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYLE GILBERT
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Credential | O.D.
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Telephone | 630-730-6683
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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 | 2846
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License Number State | CO
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