Healthcare Provider Details
I. General information
NPI: 1619148186
Provider Name (Legal Business Name): BARNET DULANEY PERKINS EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2008
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 N 22ND ST STE 120
PHOENIX AZ
85016-4962
US
IV. Provider business mailing address
63 S ROCKFORD DR STE 220
TEMPE AZ
85288-6226
US
V. Phone/Fax
- Phone: 602-955-1000
- Fax: 602-508-4830
- Phone: 602-598-7488
- Fax: 602-508-4830
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | AZ |
VIII. Authorized Official
Name:
ARTHUR
D
BROOKFIELD
Title or Position: CFO
Credential:
Phone: 602-598-7488