Provider Demographics
NPI:1043219132
Name:POPOWSKI, FELICIA TAYLOR (O D)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:TAYLOR
Last Name:POPOWSKI
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 N UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8703
Mailing Address - Country:US
Mailing Address - Phone:719-219-1312
Mailing Address - Fax:719-635-3578
Practice Address - Street 1:3155 N UNION BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8703
Practice Address - Country:US
Practice Address - Phone:719-630-3937
Practice Address - Fax:719-635-3578
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2495152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32286236Medicaid
COV06051Medicare UPIN