Provider Demographics
NPI:1033320361
Name:LISA M HAMILTON, PC
Entity Type:Organization
Organization Name:LISA M HAMILTON, PC
Other - Org Name:ACTIVE EYES, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-913-4781
Mailing Address - Street 1:5132 S. WADSWORTH BLVD
Mailing Address - Street 2:110
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123
Mailing Address - Country:US
Mailing Address - Phone:303-972-9731
Mailing Address - Fax:
Practice Address - Street 1:5132 S. WADSWORTH BLVD
Practice Address - Street 2:110
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123
Practice Address - Country:US
Practice Address - Phone:303-972-9731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT-1904152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty