Healthcare Provider Details
I. General information
NPI: 1013132158
Provider Name (Legal Business Name): BARNET DULANEY PERKINS EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1680 WILLOW CREEK ROAD BARNET DULANEY PERKINS EYE CENTER
PRESCOTT AZ
86301
US
IV. Provider business mailing address
4800 N. 22ND STREET BARNET DULANEY PERKINS EYE CENTER
PHOENIX AZ
85016
US
V. Phone/Fax
- Phone: 602-955-1000
- Fax: 602-508-4830
- Phone: 602-955-1000
- Fax: 602-508-4830
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | OSC1286 |
| License Number State | AZ |
VIII. Authorized Official
Name:
DONALD
G
SNYDER
Title or Position: CFO
Credential:
Phone: 602-955-1000