Healthcare Provider Details

I. General information

NPI: 1700823051
Provider Name (Legal Business Name): RETINAL CONSULTANTS OF ARIZONA LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E MISSOURI AVE
PHOENIX AZ
85014-2709
US

IV. Provider business mailing address

PO BOX 32530
PHOENIX AZ
85064-2530
US

V. Phone/Fax

Practice location:
  • Phone: 602-222-2221
  • Fax: 602-265-5077
Mailing address:
  • Phone: 602-265-2695
  • Fax: 602-265-5077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR BROOKFIELD
Title or Position: CFO
Credential:
Phone: 800-640-6442