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NPI Code Detail

MEDICARE: JOSHUA MARC LAHIFF O.D.

MEDICARE: JOSHUA MARC LAHIFF O.D.
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
1152W00000XOptometrist2594CO

General Provider Information

NPI Number : 1356531685
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA MARC LAHIFF O.D.
Provider Business Mailing Address
First Line : 11103 WEST AVE
Second Line : STE 6
City : SAN ANTONIO
State : TX
Zip : 78213-1370
Country : US
Telephone Number : 210-524-6803
Fax Number : 210-524-6587
Provider Business Practice Location Address
First Line : 2407 S COLLEGE AVE
Second Line : UNIT 300
City : FORT COLLINS
State : CO
Zip : 80525-1773
Country : US
Telephone Number : 970-484-3787
Fax Number : 970-484-0133
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2007
Last Update Date : 08/01/2007

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