Healthcare Provider Details
I. General information
NPI: 1851624647
Provider Name (Legal Business Name): SOUTHWESTERN EYE CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/10/2009
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3301 N MILLER RD STE 140
SCOTTSDALE AZ
85251-6990
US
IV. Provider business mailing address
63 S ROCKFORD DR STE 220
TEMPE AZ
85288-6226
US
V. Phone/Fax
- Phone: 480-947-7651
- Fax: 480-947-0274
- Phone: 602-598-7488
- Fax: 602-231-6215
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: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-598-7488