Healthcare Provider Details

I. General information

NPI: 1659325454
Provider Name (Legal Business Name): LARS FREISBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 E UNION HILLS DR STE 115
PHOENIX AZ
85050-3388
US

IV. Provider business mailing address

4045 E UNION HILLS DR STE 115
PHOENIX AZ
85050-3388
US

V. Phone/Fax

Practice location:
  • Phone: 602-368-3448
  • Fax: 602-357-3323
Mailing address:
  • Phone: 602-368-3448
  • Fax: 602-357-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number78852
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: