Provider Demographics
NPI:1063600484
Name:WILLIAM B BRITT
Entity type:Organization
Organization Name:WILLIAM B BRITT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BENTON
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-494-4449
Mailing Address - Street 1:805 S BROADWAY ST
Mailing Address - Street 2:STE 101
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5971
Mailing Address - Country:US
Mailing Address - Phone:303-494-4449
Mailing Address - Fax:303-499-5003
Practice Address - Street 1:805 S BROADWAY ST
Practice Address - Street 2:STE 101
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5971
Practice Address - Country:US
Practice Address - Phone:303-494-4449
Practice Address - Fax:303-499-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1153152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCH0003Medicare PIN