Provider Demographics
NPI:1114950250
Name:CHERRY CREEK EYE PHYSICIANS &
Entity Type:Organization
Organization Name:CHERRY CREEK EYE PHYSICIANS &
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-691-2228
Mailing Address - Street 1:4999 E KENTUCKY AVE
Mailing Address - Street 2:#202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3901
Mailing Address - Country:US
Mailing Address - Phone:303-691-2228
Mailing Address - Fax:303-759-9052
Practice Address - Street 1:4999 E KENTUCKY AVE
Practice Address - Street 2:#202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-3901
Practice Address - Country:US
Practice Address - Phone:303-691-2228
Practice Address - Fax:303-759-9052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC450548Medicare PIN