MEDICARE: RF EYE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588665269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RF EYE PC

Provider Business Mailing Address
First Line	:	2445 E WILCOX DR
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635
Country	:	US
Telephone Number	:	520-458-8131
Fax Number	:	520-458-0422

Provider Business Practice Location Address
First Line	:	2445 E WILCOX DR
Second Line	:
City	:	SIERRA VISTA
State	:	AZ
Zip	:	85635
Country	:	US
Telephone Number	:	520-458-8131
Fax Number	:	520-458-0422

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LETISHA DAWN KUDER
Credential	:
Telephone Number	:	520-458-8131

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	01/03/2019

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Directions to “RF EYE PC ” Practice Location

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