Basic Information
| Provider Information | |||||||||
| NPI: | 1548262884 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORLEANS | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5560 W 44TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802127338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034212424 | ||||||||
| FaxNumber: | 3034212155 | ||||||||
| Practice Location | |||||||||
| Address1: | 5560 W 44TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802127338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034212424 | ||||||||
| FaxNumber: | 3034212155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 05/07/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1609 | CO | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 410035420 | 01 | CO | PALMETTO GBA - RAILROAD MEDICARE | OTHER | 08916090 | 05 | CO | MEDICAID |