Provider Demographics
NPI:1134343874
Name:SPECKMAN, ROBERT REESE (OD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:REESE
Last Name:SPECKMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10050 ALLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-4913
Mailing Address - Country:US
Mailing Address - Phone:303-877-0390
Mailing Address - Fax:719-597-4110
Practice Address - Street 1:1075 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-4401
Practice Address - Country:US
Practice Address - Phone:719-597-4001
Practice Address - Fax:719-597-4110
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1760152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist