Provider Demographics
NPI:1336302702
Name:LOOCK, LINDSAY JEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:JEAN
Last Name:LOOCK
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:4008 RED CEDAR DR
Mailing Address - Street 2:UNIT D1
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8152
Mailing Address - Country:US
Mailing Address - Phone:303-471-2244
Mailing Address - Fax:303-471-4879
Practice Address - Street 1:9559 S UNIVERSITY BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7862
Practice Address - Country:US
Practice Address - Phone:303-471-2244
Practice Address - Fax:303-471-4879
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2019-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO2658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB4400Medicare PIN