Provider Demographics
NPI:1326201781
Name:PETRAITIS, MEAGAN J (OD)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:J
Last Name:PETRAITIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 E PRENTICE AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2912
Mailing Address - Country:US
Mailing Address - Phone:303-793-3000
Mailing Address - Fax:303-793-3008
Practice Address - Street 1:8400 E PRENTICE AVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2912
Practice Address - Country:US
Practice Address - Phone:303-793-3000
Practice Address - Fax:303-793-3008
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2669152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management