Search › Colorado › 152W00000X
Timothy Landis, OD
NPI 1578555645 · on the registry since 2005 · sole proprietor
Practice
- Address
- 559 Vincent St Bldg 959
Peterson Afb, CO 80914 - Phone
- (702) 653-3010
- Fax
- (702) 653-3023
- Organisation at this address
- 21st Medical Group
21st Medgrp-PetersonInferred from a shared address, not stated in the registry. - Clinicians at this address
- 77
Additional practice sites
- 838 Somerset Blvd, Charles Town, WV
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152W00000X
- Licence states on file
- KY, WV
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-01-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado