Provider Demographics
NPI:1972067411
Name:LAKEWOOD VISION, PLLC
Entity type:Organization
Organization Name:LAKEWOOD VISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MURPHY
Authorized Official - Last Name:GARTH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:970-471-1864
Mailing Address - Street 1:1535 S KIPLING PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6258
Mailing Address - Country:US
Mailing Address - Phone:303-937-8655
Mailing Address - Fax:
Practice Address - Street 1:1535 S KIPLING PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6258
Practice Address - Country:US
Practice Address - Phone:303-937-8655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty