Individual
DR. BRENT ROY PHINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
515 MAIN ST, WINDSOR, CO 80550-5131
(970) 460-0154
(970) 460-3032
Mailing address
515 MAIN ST, WINDSOR, CO 80550-5131
(970) 460-0154
(970) 460-3032
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2598
CO
152W00000X
Optometrist
3995TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031227
—
WA
01
—
22095
L&I PROVIDER #
WA
01
—
5493150001
DMERC
WA
01
—
5856769
AETNA
WA
01
—
911035418-BU1061
REGENCE
WA
Enumeration date
10/23/2006
Last updated
01/26/2022
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