Provider Demographics
NPI:1114910759
Name:CORNEAL CONSULTANTS OF COLORADO PC
Entity Type:Organization
Organization Name:CORNEAL CONSULTANTS OF COLORADO PC
Other - Org Name:COLORADO EYE CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:FORSTOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-730-0404
Mailing Address - Street 1:1501 W MINERAL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5612
Mailing Address - Country:US
Mailing Address - Phone:303-730-0404
Mailing Address - Fax:303-730-6163
Practice Address - Street 1:1501 W MINERAL AVE STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5612
Practice Address - Country:US
Practice Address - Phone:303-730-0404
Practice Address - Fax:720-647-4210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B4508OtherBLUE CROSS BLUE SHIELD
CC7541OtherRAILROAD MEDICARE
CO04005146Medicaid
CO04005146Medicaid
CC7541OtherRAILROAD MEDICARE
CO0273150001Medicare NSC