Provider Demographics
NPI:1245497452
Name:JOHN L SCHACHET OD PC
Entity type:Organization
Organization Name:JOHN L SCHACHET OD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHACHET
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-771-4221
Mailing Address - Street 1:8586 E ARAPAHOE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1433
Mailing Address - Country:US
Mailing Address - Phone:303-771-4221
Mailing Address - Fax:
Practice Address - Street 1:8586 E ARAPAHOE RD
Practice Address - Street 2:STE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1433
Practice Address - Country:US
Practice Address - Phone:303-771-4221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO825152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT60271Medicare UPIN