Healthcare Provider Details

I. General information

NPI: 1295710002
Provider Name (Legal Business Name): SCOTTSDALE EYE SURGERY CENTER, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8414 N 90TH ST
SCOTTSDALE AZ
85258-4395
US

IV. Provider business mailing address

8414 N 90TH ST
SCOTTSDALE AZ
85258-4395
US

V. Phone/Fax

Practice location:
  • Phone: 480-949-1208
  • Fax: 480-994-3316
Mailing address:
  • Phone: 480-949-1208
  • Fax: 480-994-3316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberOSC0047
License Number StateAZ

VIII. Authorized Official

Name: MISS JOYCE R. SCHWEIKERT
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 480-291-7963