Madison Street Provider Network INC

NPI #1063019214 in Centennial, Colorado

Provider Information

NPI Number: 1063019214
Entity Type: Organization
Organization Name: Madison Street Provider Network INC
Subpart: Yes (part of a larger organization)
Parent Organization: MADISON STREET PROVIDER NETWORK INC
Primary Specialty: Ophthalmology
Enumeration Date: Oct 1, 2020
Last Updated: Oct 1, 2020

Practice Location

Address: 6881 S YOSEMITE ST
City: Centennial
State: Colorado
ZIP Code: 80112-1406
Phone: (303) 733-2020

Authorized Official

Name: GEORGE L NEAL
Title: PRESIDENT
Phone: (469) 214-0144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Ophthalmology	207W00000X	Primary

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DR. Lawrence D Spivack, M.D.	Ophthalmology	Centennial	AI Deep Dive
DR. Richard A Levinson, M.D.	Ophthalmology	Denver	AI Deep Dive
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