National Provider Identifier Database

MARC A PROVENCHER, OD – NPI #1184794745
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.


Contact Information

MARC A PROVENCHER, OD
4050 S TIMBERLINE RD UNIT 120
FORT COLLINS, CO80525-6023
Phone: 970-282-8888
Fax: 970-282-8484
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X
Corneal and Contact Management 152WC0802X

* Indicates primary specialty

NPI Profile & details for MARC A PROVENCHER

NPI Number 1184794745
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 11/09/2006
Last updated 11/02/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • CO License #: 2025
  • WY License #: 209T
  • Other: 1659005387 TYPE 2 NPI
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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