Provider Demographics
NPI:1366565434
Name:UNITED EYE CENTERS PC
Entity type:Organization
Organization Name:UNITED EYE CENTERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-761-2020
Mailing Address - Street 1:950 EAST HARVARD AVENUE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210
Mailing Address - Country:US
Mailing Address - Phone:303-761-2020
Mailing Address - Fax:303-722-7367
Practice Address - Street 1:9330 S UNIVERSITY BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5065
Practice Address - Country:US
Practice Address - Phone:303-346-8400
Practice Address - Fax:303-346-1785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2110152W00000X
CO23075207W00000X
CO32608207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04010245Medicaid
CO04010245Medicaid