Organization
COLORADO WEST OPHTHALMOLOGY ASSOC. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETICIA C WARE (ADMINISTRATIVE ASSISTANT)
(970) 249-1210
Entity
Organization
Contact information
Practice address
1800 E. PAVILION PLACE, SUITE B, MONTROSE, CO 81401
(970) 249-1210
(970) 249-3057
Mailing address
1800 E PAVILION PL UNIT B, MONTROSE, CO 81401-5499
(970) 249-1210
(970) 249-3057
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04001491
—
CO
01
—
98604
BLUE CROSS BLUESHIELD
—
01
—
CJ7703
RAILROAD MEDICARE
—
Enumeration date
01/18/2007
Last updated
03/09/2021
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