Healthcare Provider Details

I. General information

NPI: 1609106145
Provider Name (Legal Business Name): BARNET DULANEY PERKINS EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S WHITE MOUNTAIN RD SUITE 300
SHOW LOW AZ
85901-7111
US

IV. Provider business mailing address

63 S ROCKFORD DR STE 220
TEMPE AZ
85288-6226
US

V. Phone/Fax

Practice location:
  • Phone: 928-537-3937
  • Fax: 928-537-4729
Mailing address:
  • Phone: 602-598-7488
  • Fax: 602-508-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number858
License Number StateAZ

VIII. Authorized Official

Name: ARTHUR D BROOKFIELD
Title or Position: CFO
Credential:
Phone: 602-598-7488