Healthcare Provider Details

I. General information

NPI: 1023289097
Provider Name (Legal Business Name): BARNET DULANEY PERKINS EYE CENTE R
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 N 22ND ST
PHOENIX AZ
85016-4701
US

IV. Provider business mailing address

63 S ROCKFORD DR STE 220
TEMPE AZ
85288-6226
US

V. Phone/Fax

Practice location:
  • Phone: 602-955-1000
  • Fax: 602-508-4830
Mailing address:
  • Phone: 602-977-6076
  • Fax: 602-508-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number67780
License Number StateAZ

VIII. Authorized Official

Name: MR. ARTHUR D BROOKFIELD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-598-7488