Provider Demographics
NPI:1063464048
Name:WINNICK, RICHARD EUGENE (OD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:EUGENE
Last Name:WINNICK
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 1:7151 W ALASKA DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3216
Mailing Address - Country:US
Mailing Address - Phone:303-936-4395
Mailing Address - Fax:303-936-3756
Practice Address - Street 1:7151 W ALASKA DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3216
Practice Address - Country:US
Practice Address - Phone:303-936-4395
Practice Address - Fax:303-936-3756
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist