Provider Demographics
NPI:1437181781
Name:DR ROGER A HULME OD PC
Entity Type:Organization
Organization Name:DR ROGER A HULME OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:HULME
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-667-5511
Mailing Address - Street 1:3850 GRANT AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8431
Mailing Address - Country:US
Mailing Address - Phone:970-667-5511
Mailing Address - Fax:970-292-5213
Practice Address - Street 1:2677 N TAFT AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538
Practice Address - Country:US
Practice Address - Phone:970-667-5511
Practice Address - Fax:970-292-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1220152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
001951048OtherHIGHMARK BCBS
906772OtherBLOCK VISION
CO906772107603OtherEYE SPECIALISTS
4534960OtherAETNA
CO649971OtherANTHEM
693852OtherCOVENTRY HEALTH CARE
CO1220OtherSTATE LICENSE
1528036829OtherNPI TYPE 1
410038740OtherRAIL ROAD MEDICARE
CO693901OtherMEDICARE
99893OtherWELLMARK BCBS
3633036OtherCIGNA
COHU41113OtherANTHEM
COHU41113OtherANTHEM
906772OtherBLOCK VISION
COC806846Medicare PIN
3633036OtherCIGNA
CO806847Medicare PIN