Healthcare Provider Details

I. General information

NPI: 1225279060
Provider Name (Legal Business Name): MATTHEW S. PIPER, O.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 03/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 W APACHE TRL
APACHE JUNCTION AZ
85220-5204
US

IV. Provider business mailing address

130 W GUADALUPE RD APT 2072
GILBERT AZ
85233-3328
US

V. Phone/Fax

Practice location:
  • Phone: 480-983-9557
  • Fax: 480-983-9559
Mailing address:
  • Phone: 480-290-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW S. PIPER
Title or Position: PRESIDENT
Credential: O.D.
Phone: 480-290-3389