Provider Demographics
NPI:1598920548
Name:HILBERT, MICHAEL M (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:HILBERT
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 1:718 E PLATTE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3620
Mailing Address - Country:US
Mailing Address - Phone:970-867-3342
Mailing Address - Fax:970-867-7751
Practice Address - Street 1:718 E PLATTE AVE
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3620
Practice Address - Country:US
Practice Address - Phone:970-867-3342
Practice Address - Fax:970-867-7751
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2657152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01130030Medicaid
COCO40521Medicare PIN