Provider Demographics
NPI:1073105144
Name:LISA M HAMILTON, PC
Entity Type:Organization
Organization Name:LISA M HAMILTON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
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:303-972-9731
Mailing Address - Street 1:5132 S WADSWORTH BLVD UNIT 110
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2213
Mailing Address - Country:US
Mailing Address - Phone:303-972-9731
Mailing Address - Fax:303-971-0523
Practice Address - Street 1:1268 INTERQUEST PKWY STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-4209
Practice Address - Country:US
Practice Address - Phone:303-972-9731
Practice Address - Fax:303-971-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty