Provider Demographics
NPI:1720044746
Name:AURORA EYE PHYSICIANS PC
Entity Type:Organization
Organization Name:AURORA EYE PHYSICIANS PC
Other - Org Name:BURCHAM EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OF AURORA EYE PHYSICIANS PC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:BURCHAM
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:303-340-4600
Mailing Address - Street 1:750 POTOMAC ST
Mailing Address - Street 2:SUITE 223
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011
Mailing Address - Country:US
Mailing Address - Phone:303-340-4600
Mailing Address - Fax:303-367-8300
Practice Address - Street 1:750 POTOMAC ST
Practice Address - Street 2:SUITE 223
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011
Practice Address - Country:US
Practice Address - Phone:303-340-4600
Practice Address - Fax:303-367-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20123207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01201235Medicaid
COCE7018Medicare PIN
CO01201235Medicaid