Provider Demographics
NPI:1609902576
Name:KAISER, DONALD PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:PAUL
Last Name:KAISER
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 1:30054 UPPER BEAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7708
Mailing Address - Country:US
Mailing Address - Phone:303-674-7086
Mailing Address - Fax:
Practice Address - Street 1:400 INVERNESS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5830
Practice Address - Country:US
Practice Address - Phone:303-202-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1640152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist