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DR. DEREK WAYNE ASHBY OD

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1700048329

Individual Registrant:
DR. DEREK WAYNE ASHBY OD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
326 DOZIER AVE  CANON CITY, CO 81212-2706 US
Tel: 719-276-0344  Fax: 719-269-7446

Contact information for business:
326 DOZIER AVE  CANON CITY, CO 81212-2706 US
Tel: 719-276-0344  Fax: 719-269-7446

Registration Information:
NPI: 1700048329
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
COOPT-2652

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
87751747CO05
GROUP NPI137698392401
RAILROAD MEDICAREP0082717201
OFFICE GROUP NPI167952520801




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