Provider Demographics
NPI:1528036829
Name:HULME, ROGER ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:ALAN
Last Name:HULME
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2677 N TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3121
Mailing Address - Country:US
Mailing Address - Phone:970-667-5511
Mailing Address - Fax:
Practice Address - Street 1:2677 N TAFT AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3121
Practice Address - Country:US
Practice Address - Phone:970-667-5511
Practice Address - Fax:970-292-5213
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1220152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001951048OtherHIGHMARK BCBS, PA
CO649971OtherANTHEM
CO1220OtherSTATE LICENSE
3633036OtherCIGNA
4534960OtherAETNA
693852OtherCOVENTRY HEALTH CARE
CO1437181781OtherNPI TYPE 11
906772107603OtherEYESPECIALISTS
99893OtherWELLMARK BCBS IOWA
COMH0145917OtherDEA
CO806846Medicare PIN
CO806847Medicare PIN
CO1437181781OtherNPI TYPE 11
COMH0145917OtherDEA