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General NPI Number Information
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NPI Number | 1831714237
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Entity Type | Organization
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Legal Business Name | RETINA CONSULTANTS OF SOUTHERN COLORADO P C
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | 10035 PEARL PASS VIEW SUITE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924
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Country | US
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Telephone | 719-473-9595
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Fax | 719-227-0669
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Provider Business Mailing Address
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Address Line | 10035 PEARL PASS VIEW SUITE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924
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Country | US
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Telephone | 719-473-9595
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Fax | 719-227-0669
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Authorized Official
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Title or Position | FRONT OFFICE MANAGER
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Name | CHRISSY BEAL
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Credential |
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Telephone | 719-473-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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