Provider Demographics
NPI:1427079151
Name:STRAUB, WILLIAM CLAUDE (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLAUDE
Last Name:STRAUB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2249 W EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3147
Mailing Address - Country:US
Mailing Address - Phone:970-669-4587
Mailing Address - Fax:970-669-4588
Practice Address - Street 1:2249 W EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3147
Practice Address - Country:US
Practice Address - Phone:970-669-4587
Practice Address - Fax:970-669-4588
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO863152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT60893Medicare UPIN