Individual
DR. NILES F UTLAUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 ALPINE AVE, STE 270, BOULDER, CO 80304-3495
(303) 440-5033
(303) 440-0889
Mailing address
1155 ALPINE AVE, STE 270, BOULDER, CO 80304-3495
(303) 440-5033
(303) 440-0889
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
22970
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04011409
—
CO
Enumeration date
12/20/2006
Last updated
10/16/2007
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