Healthcare Provider Details

I. General information

NPI: 1053035493
Provider Name (Legal Business Name): BILTMORE EYE PHYSICIANS PC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N. 32ND ST. #280
PHOENIX AZ
85018
US

IV. Provider business mailing address

4400 N. 32ND ST. #280
PHOENIX AZ
85018
US

V. Phone/Fax

Practice location:
  • Phone: 602-266-6888
  • Fax: 602-266-6895
Mailing address:
  • Phone: 602-266-6888
  • Fax: 602-266-6895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT H BULLINGTON JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 602-266-6888