Provider Demographics
NPI:1568423705
Name:BARTHRAM, SANDRA KAYE (OD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAYE
Last Name:BARTHRAM
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 1:70 SAGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-8314
Mailing Address - Country:US
Mailing Address - Phone:719-290-6183
Mailing Address - Fax:
Practice Address - Street 1:534 E HYMAN AVE
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1955
Practice Address - Country:US
Practice Address - Phone:970-925-3020
Practice Address - Fax:970-925-3198
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2454152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist