Provider Demographics
NPI:1528054665
Name:SPINOZZI, LOUIS A (OD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:A
Last Name:SPINOZZI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9835 S PARKER RD
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8815
Mailing Address - Country:US
Mailing Address - Phone:303-841-3937
Mailing Address - Fax:303-805-4370
Practice Address - Street 1:9835 S PARKER RD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-8815
Practice Address - Country:US
Practice Address - Phone:303-841-3937
Practice Address - Fax:303-805-4370
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO908152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU19787Medicare UPIN
COCF 3913Medicare ID - Type UnspecifiedGROUP #
COCF3903Medicare PIN