Organization
AMEDCO COLORADO PLLC
Active
Other names
Lakewood Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS M CAMPBELL D.O. (OWNER/MEDICAL DIRECTOR)
(303) 237-5401
Entity
Organization
Contact information
Practice address
1861 WADSWORTH BLVD, LAKEWOOD, CO 80214-5225
(303) 237-5401
(303) 237-9638
Mailing address
1861 WADSWORTH BLVD, LAKEWOOD, CO 80214-5225
(303) 237-5401
(303) 237-9638
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COAAA3088
MEDICARE AMEDCO CO PLLC PTAN
CO
Enumeration date
08/09/2012
Last updated
10/15/2012
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