Provider Demographics
NPI:1316280258
Name:DOCTORS OPTICAL, INC.
Entity type:Organization
Organization Name:DOCTORS OPTICAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-757-6747
Mailing Address - Street 1:1685 S COLORADO BLVD
Mailing Address - Street 2:UNIT O
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4000
Mailing Address - Country:US
Mailing Address - Phone:303-757-6747
Mailing Address - Fax:303-757-6897
Practice Address - Street 1:700 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4532
Practice Address - Country:US
Practice Address - Phone:303-825-2286
Practice Address - Fax:303-825-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62273736Medicaid
COCO8407033OtherMEDICARE SUBSCRIBER NUMBER
COCO8407033OtherMEDICARE SUBSCRIBER NUMBER