Provider Demographics
NPI:1932470085
Name:ASSOCIATED OPTOMETRIC PHYSICIANS, INC
Entity Type:Organization
Organization Name:ASSOCIATED OPTOMETRIC PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-433-5068
Mailing Address - Street 1:1325 DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-5120
Mailing Address - Country:US
Mailing Address - Phone:970-233-5035
Mailing Address - Fax:970-669-7518
Practice Address - Street 1:1325 DENVER AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-5120
Practice Address - Country:US
Practice Address - Phone:928-681-3533
Practice Address - Fax:928-681-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-21
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1800152W00000X
COOPT.0003341152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU90908Medicare UPIN