Archdale, Theodore William

Archdale, Theodore William is an individual health care provider with primary practice located at 1541 S 8Th St , Colorado Springs CO 80905-1923. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Archdale, Theodore William can be contacted via phone (719) 577-4400.

Contact Information

Primary practice address
1541 S 8Th St Colorado Springs CO 80905-1923
Phone: (719) 577-4400
Fax: (719) 577-4954
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1466 Colorado

Profile Details

NPI number 1588660161
LBN Legal business name Archdale, Theodore William
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Nov 23rd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588660161 NPPES
Colorado MEDICAID 26777312
Colorado MEDICAID 08014664
Colorado MEDICAID 99752212

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