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General NPI Number Information
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NPI Number | 1063685824
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Entity Type | Organization
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Legal Business Name | CARRIKER EYE CENTER, PC
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 502 W NORTHVIEW AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-8742
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Country | US
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Telephone | 602-274-1703
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Fax | 602-274-3216
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Provider Business Mailing Address
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Address Line | 502 W NORTHVIEW AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-8742
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Country | US
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Telephone | 602-274-1703
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Fax | 602-274-3216
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RICHARD G CARRIKER
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Credential | MD
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Telephone | 602-274-1703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD13920
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License Number State | AZ
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