Healthcare Provider Details

I. General information

NPI: 1396965331
Provider Name (Legal Business Name): BARNET DULANEY PERKINS EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BARNET DUALNEY PERKINS EYE CENTER 1375 W. 16TH STREET, SUITE B
YUMA AZ
85364
US

IV. Provider business mailing address

BARNET DULANEY PERKINS EYE CENTER 4800 N. 22ND STREET
PHOENIX AZ
85016
US

V. Phone/Fax

Practice location:
  • Phone: 602-955-1000
  • Fax: 602-508-4830
Mailing address:
  • Phone: 602-955-1000
  • Fax: 602-508-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberWCKNJ
License Number StateAZ

VIII. Authorized Official

Name: DONALD G SNYDER
Title or Position: CFO
Credential:
Phone: 602-955-1000