Provider Demographics
NPI:1790874808
Name:BRITT, WILLIAM B (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:BRITT
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:805 S BROADWAY ST
Mailing Address - Street 2:STE 101
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5971
Mailing Address - Country:US
Mailing Address - Phone:303-494-4449
Mailing Address - Fax:303-499-5003
Practice Address - Street 1:805 S BROADWAY
Practice Address - Street 2:STE 101
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5971
Practice Address - Country:US
Practice Address - Phone:303-494-4449
Practice Address - Fax:303-499-5003
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1153152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCH0013Medicare PIN
COT60845Medicare UPIN