Provider Demographics
NPI:1043754419
Name:ALEX ZEMKE, OD, PLLC
Entity Type:Organization
Organization Name:ALEX ZEMKE, OD, PLLC
Other - Org Name:INSIGHT EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-238-9900
Mailing Address - Street 1:2290 KIPLING STREET
Mailing Address - Street 2:UNIT 1
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1578
Mailing Address - Country:US
Mailing Address - Phone:303-238-9900
Mailing Address - Fax:303-238-8527
Practice Address - Street 1:2290 KIPLING STREET
Practice Address - Street 2:UNIT 1
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1578
Practice Address - Country:US
Practice Address - Phone:303-238-9900
Practice Address - Fax:303-238-8527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT0002973152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18001530Medicaid