Provider Demographics
NPI:1013023951
Name:PETER G. HOVLAND, M.D.,PHD.
Entity Type:Organization
Organization Name:PETER G. HOVLAND, M.D.,PHD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOVLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-778-1910
Mailing Address - Street 1:850 E HARVARD AVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5031
Mailing Address - Country:US
Mailing Address - Phone:303-778-1910
Mailing Address - Fax:303-698-2694
Practice Address - Street 1:850 E HARVARD AVE
Practice Address - Street 2:SUITE 155
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5031
Practice Address - Country:US
Practice Address - Phone:303-778-1910
Practice Address - Fax:303-698-2694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44590207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COI09882Medicare UPIN