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General NPI Number Information
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NPI Number | 1922090844
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Entity Type | Organization
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Legal Business Name | NATURAL EYES LASER AND SURGERY CENTER, LLLP
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 2485 E. PIKES PEAK AVE
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City | COLO. SPRINGS
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State | CO
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Zip | 80909
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Country | US
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Telephone | 719-634-2001
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Fax | 719-634-2211
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Provider Business Mailing Address
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Address Line | 2485 E. PIKES PEAK AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909
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Country | US
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Telephone | 719-634-2001
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Fax | 719-634-2211
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOHN R. WRIGHT
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Credential | D.O.
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Telephone | 719-634-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0304
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 160559
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License Number State | CO
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