Provider Demographics
NPI:1811950496
Name:HOLLAND, JEFFREY BOYACE (ODPC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:BOYACE
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:ODPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 COLLEGE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-7300
Mailing Address - Country:US
Mailing Address - Phone:303-444-3092
Mailing Address - Fax:303-938-0572
Practice Address - Street 1:1350 COLLEGE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7300
Practice Address - Country:US
Practice Address - Phone:303-444-3092
Practice Address - Fax:303-938-0572
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2298152WC0802X
COCO2298152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO474488Medicare ID - Type Unspecified
CO72971746Medicaid
COU91858Medicare UPIN