Provider Demographics
NPI:1669489795
Name:NELMS, PATRICK GUY (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:GUY
Last Name:NELMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:12792 W ALAMEDA PKWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2858
Mailing Address - Country:US
Mailing Address - Phone:303-986-5565
Mailing Address - Fax:303-984-2111
Practice Address - Street 1:12792 W ALAMEDA PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2858
Practice Address - Country:US
Practice Address - Phone:303-986-5565
Practice Address - Fax:303-984-2111
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1073152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT60829Medicare UPIN
C490848Medicare PIN