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NPI Code Detail

MEDICARE: DR. CRISTY L WITT OD

MEDICARE: DR. CRISTY L WITT OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT.0003056CO
2152W00000XOptometristTA2363MD

General Provider Information

NPI Number : 1073946398
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRISTY L WITT OD
Provider Business Mailing Address
First Line : 15159 E COLFAX AVE UNIT B
Second Line :
City : AURORA
State : CO
Zip : 80011-5707
Country : US
Telephone Number : 303-341-5437
Fax Number : 719-542-0425
Provider Business Practice Location Address
First Line : 15159 E COLFAX AVE UNIT B
Second Line :
City : AURORA
State : CO
Zip : 80011-5707
Country : US
Telephone Number : 303-341-5437
Fax Number : 719-542-0425
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2013
Last Update Date : 10/08/2014

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