DR. WILBUR FRED MEIKLEJOHN (NPI# 1629037643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629037643 |
| Entity Type | Individual |
| Full Name | DR. WILBUR FRED MEIKLEJOHN |
| Credential | O.D. |
| Practice Address |
4112 Outlook Blvd 11cp Pueblo CO 81008-1667 |
| Practice Telephone | 7185531010 |
| Practice Fax Number | 7195531088 |
| Mailing Telephone | 7195531010 |
| Mailing Fax Number | 7195531088 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 757 | CO | Eye and Vision Services Providers |
| Street Address |
4112 OUTLOOK BLVD 11CP |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447233432 | Richard N. Nanes | Emergency Medicine | 4112 Outlook Blvd, Suite 37, Pueblo, CO 81008-1667 | 2005-11-22 |
| 1487262689 | Patricia A Turner | Nurse Practitioner | 4112 Outlook Blvd, Pueblo, CO 81008-1667 | 2020-07-14 |
| 1932648490 | Jordan T. Rhodes | Physical Therapist | 4112 Outlook Blvd, Pueblo, CO 81008-1667 | 2017-02-16 |
| 1952769812 | Samantha Correia | Physical Therapist | 4112 Outlook Blvd, Pueblo, CO 81008-1667 | 2016-02-08 |
| 1003295346 | Karen Bishop | Physical Therapist | 4112 Outlook Blvd, Ste 96, Pueblo, CO 81008-1667 | 2015-05-19 |
| 1871992321 | Ryanne Leah Gromatzky | Physical Therapist | 4112 Outlook Blvd, 96, Pueblo, CO 81008-1667 | 2014-08-21 |
| 1801218284 | Pamela Drummond | Registered Nurse | 4112 Outlook Blvd, Suite 37, Pueblo, CO 81008-1667 | 2014-01-20 |
| 1568896959 | Sarah Elizabeth Whiteman | Physical Therapist | 4112 Outlook Blvd, Suite 96, Pueblo, CO 81008-1667 | 2013-08-21 |
| 1336487297 | Leslie Dallas | Physical Therapist | 4112 Outlook Blvd, Suite 96, Pueblo, CO 81008-1667 | 2013-01-27 |
| 1780942441 | Betty Ann Massino | Massage Therapist | 4112 Outlook Blvd, Suite #96, Pueblo, CO 81008-1667 | 2012-05-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
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| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689234742 | Melanie Rae Niehus | Optometrist | 4200 N Freeway Rd # 120, Pueblo, CO 81008-2153 | 2019-06-19 |
| 1457817405 | Rocky Mountain Eye Center, Inc., A Colorado Provider Network | Optometrist | 711 W Abriendo Ave, Pueblo, CO 81004-1559 | 2019-02-14 |
| 1417461823 | Yah Vision | Optometrist | 2568 Taylor Ln, Pueblo, CO 81005 | 2017-11-21 |
| 1154761765 | Heather N Kim | Optometrist | 4206 N Freeway Rd, Pueblo, CO 81008-2060 | 2013-06-27 |
| 1568719136 | Joseph Gowen, O.d. and Associates, LLC | Optometrist | 4420 N. Freeway Rd., Pueblo, CO 81008 | 2012-08-13 |
| 1538460316 | Eye Care of Colorado, P.C. | Optometrist | 3279 Dillon Dr, Pueblo, CO 81008-1005 | 2010-11-09 |
| 1235343765 | Abba Eye Care PC | Optometrist | 900 W Northern Ave, Pueblo, CO 81004-3124 | 2007-05-10 |
| 1740494269 | Abba Eye Care PC | Optometrist | 1650 W Us Highway 50, Pueblo, CO 81008-1613 | 2007-05-10 |
| 1821168790 | Alison C. House | Optometrist | 1821 Fortino Blvd, Pueblo, CO 81008-1892 | 2006-11-08 |
| 1508962895 | Anica Lehmann | Optometrist | 4206 North Freeway, Pueblo, CO 81008 | 2006-09-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.