Provider Demographics
NPI:1881961316
Name:FRONT RANGE EYE PHYSICIANS PC
Entity type:Organization
Organization Name:FRONT RANGE EYE PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:B
Authorized Official - Last Name:KARBASSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-772-3611
Mailing Address - Street 1:205 S MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-1716
Mailing Address - Country:US
Mailing Address - Phone:303-772-3611
Mailing Address - Fax:303-772-3609
Practice Address - Street 1:205 S MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-1716
Practice Address - Country:US
Practice Address - Phone:303-772-3611
Practice Address - Fax:303-772-3609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty