Individual
MR. FRANK E PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1860 WOODMOOR DR, STE 103, MONUMENT, CO 80132-9093
(719) 488-2042
(719) 488-0965
Mailing address
1860 WOODMOOR DR, STE 103, MONUMENT, CO 80132-9093
(719) 488-2042
(719) 488-0965
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1007
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08010076
—
CO
01
—
P01292813
RAILROAD MEDICARE
CO
Enumeration date
09/13/2005
Last updated
03/18/2016
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