Healthcare Provider Details

I. General information

NPI: 1700828423
Provider Name (Legal Business Name): SOUTHWESTERN EYE CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 COLONIA DE SALUD #A100
SIERRA VISTA AZ
85635-2487
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 520-459-6860
  • Fax: 520-459-6858
Mailing address:
  • Phone: 602-977-6076
  • Fax: 602-231-6215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARTHUR D BROOKFIELD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 602-598-7488