Provider Demographics
NPI:1679928048
Name:PARK MEADOWS VISION ASSOCIATES PLLC
Entity Type:Organization
Organization Name:PARK MEADOWS VISION ASSOCIATES PLLC
Other - Org Name:DR. JAMES SIMONSON AND ASSOCIATES OD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAIMIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-649-9500
Mailing Address - Street 1:8405 PARK MEADOWS CENTER DRIVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5025
Mailing Address - Country:US
Mailing Address - Phone:303-649-9500
Mailing Address - Fax:303-649-9133
Practice Address - Street 1:8405 PARK MEADOWS CENTER DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5005
Practice Address - Country:US
Practice Address - Phone:303-649-9500
Practice Address - Fax:303-649-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1045152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty