Provider Demographics
NPI:1982655767
Name:EYE ASSOCIATES OF COLORADO SPRINGS, PC
Entity Type:Organization
Organization Name:EYE ASSOCIATES OF COLORADO SPRINGS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-471-2020
Mailing Address - Street 1:2770 N. UNION BLVD.
Mailing Address - Street 2:SUITE 240
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909
Mailing Address - Country:US
Mailing Address - Phone:719-471-2020
Mailing Address - Fax:719-633-7379
Practice Address - Street 1:2770 N. UNION BLVD.
Practice Address - Street 2:SUITE 240
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909
Practice Address - Country:US
Practice Address - Phone:719-471-2020
Practice Address - Fax:719-633-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04958088Medicaid
95808Medicare UPIN
COC95808Medicare PIN