Organization · NPI-2
Ophthalmic Consultants Of Arizona, LLC
Clinic/Center · Prescott Valley, AZ
NPI number1891320453
StatusActive
Last updated in NPPESFeb 19, 2021
Details
- NPI
- 1891320453
- Entity type
- Organization (NPI-2)
- Legal business name
- Ophthalmic Consultants Of Arizona, LLC
- Organization subpart
- No
- Enumeration date
- Mar 4, 2020
- Certification date
- Feb 19, 2021
- Last updated
- Feb 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Yavapai Eye Care Surgery Center B (Doing Business As)
Practice location
7840 E State Route 69 Ste A5aPrescott Valley, AZ 86314-2280
Phone 928-775-9393 · Fax 928-772-1279
Mailing address
5374 N Hondo DrPrescott Valley, AZ 86314-9343
Phone 928-775-9393 · Fax 928-772-1279
Other practice locations
412 Whipple St
Prescott, AZ 86301-1712
Prescott, AZ 86301-1712
Phone 928-771-9000
Authorized official
Jared G Smedley
Authorized Official
9287759393
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