Provider Demographics
NPI:1578599114
Name:COLORADO EYE SURGEONS, P.C.
Entity Type:Organization
Organization Name:COLORADO EYE SURGEONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TARRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:NUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-722-9923
Mailing Address - Street 1:950 E HARVARD AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7009
Mailing Address - Country:US
Mailing Address - Phone:303-722-9923
Mailing Address - Fax:
Practice Address - Street 1:950 E HARVARD AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7009
Practice Address - Country:US
Practice Address - Phone:303-722-9923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43898207W00000X
CO44663207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84833378Medicaid
COC803680Medicare ID - Type Unspecified