Provider Demographics
NPI:1730470543
Name:EYE ASSOCIATES OF COLORADO, P.C.
Entity Type:Organization
Organization Name:EYE ASSOCIATES OF COLORADO, P.C.
Other - Org Name:EYE CARE COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-832-7002
Mailing Address - Street 1:1245 E COLFAX AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2238
Mailing Address - Country:US
Mailing Address - Phone:303-832-7002
Mailing Address - Fax:303-832-8005
Practice Address - Street 1:1245 E COLFAX AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2238
Practice Address - Country:US
Practice Address - Phone:303-832-7002
Practice Address - Fax:303-832-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1886152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO87058537Medicaid