MEDICARE: PEAK VIEW OPTOMETRY FT CARSON CLINIC PLLC

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

General Provider Information

NPI Number	:	1972456929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK VIEW OPTOMETRY FT CARSON CLINIC PLLC

Provider Business Mailing Address
First Line	:	6110 MARTINEZ ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913-2048
Country	:	US
Telephone Number	:	719-368-4003
Fax Number	:

Provider Business Practice Location Address
First Line	:	6110 MARTINEZ ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913-2048
Country	:	US
Telephone Number	:	719-368-4003
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	MICHAEL SMITH GITCHEL
Credential	:	OD
Telephone Number	:	727-492-0859

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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