MEDICARE: MARLA R MCHUGH 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
1	152W00000X	Optometrist	2128	CO

General Provider Information

NPI Number	:	1639109234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA R MCHUGH OD

Provider Business Mailing Address
First Line	:	1097 LEYDEN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-4636
Country	:	US
Telephone Number	:	303-322-5322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1399 S HAVANA ST
Second Line	:	SUITE 101
City	:	AURORA
State	:	CO
Zip	:	80012-4020
Country	:	US
Telephone Number	:	303-750-7621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/08/2007

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