Provider Demographics
NPI:1598810707
Name:SEIFERT, DAVID A (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:SEIFERT
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 1:3190 S WADSWORTH BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-4899
Mailing Address - Country:US
Mailing Address - Phone:303-988-5858
Mailing Address - Fax:303-988-3651
Practice Address - Street 1:3190 S WADSWORTH BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-4899
Practice Address - Country:US
Practice Address - Phone:303-988-5858
Practice Address - Fax:303-988-3651
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO729152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7290OtherEYEMED
921411OtherBLOCK VISION
BC23786OtherSPECRERA
560731Medicare UPIN
78713Medicare ID - Type Unspecified