Provider Demographics
NPI:1427000868
Name:ALAN J MARGOLIS MD PC
Entity Type:Organization
Organization Name:ALAN J MARGOLIS MD PC
Other - Org Name:MARGOLIS VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-797-1150
Mailing Address - Street 1:10099 RIDGEGATE PKWY
Mailing Address - Street 2:SUITE 365
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5531
Mailing Address - Country:US
Mailing Address - Phone:303-797-1150
Mailing Address - Fax:303-797-0169
Practice Address - Street 1:10099 RIDGEGATE PKWY
Practice Address - Street 2:SUITE 365
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5531
Practice Address - Country:US
Practice Address - Phone:303-797-1150
Practice Address - Fax:303-797-0169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30863207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01308634Medicaid
CO30863OtherCO LIC
COBM1922079OtherDEA
CO30863OtherCO LIC
CO01308634Medicaid