Provider Demographics
NPI:1528064532
Name:JAMES, TIMOTHY W (OD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:JAMES
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 1:6179 S BALSAM WAY
Mailing Address - Street 2:STE 130
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3092
Mailing Address - Country:US
Mailing Address - Phone:303-904-0748
Mailing Address - Fax:
Practice Address - Street 1:6179 S BALSAM WAY
Practice Address - Street 2:STE 130
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3092
Practice Address - Country:US
Practice Address - Phone:303-973-1948
Practice Address - Fax:303-904-1057
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO2219152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO461708Medicare ID - Type Unspecified
CO4417Medicare UPIN