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General NPI Number Information
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NPI Number | 1184730251
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Entity Type | Organization
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Legal Business Name | MILLENNIUM VISION INC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 18325 N ALLIED WAY SUITE 100
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City | PHOENIX
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State | AZ
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Zip | 85054-3106
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Country | US
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Telephone | 602-467-4966
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Fax | 480-419-5401
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Provider Business Mailing Address
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Address Line | 18325 N ALLIED WAY STE 100
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City | PHOENIX
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State | AZ
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Zip | 85054-3106
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Country | US
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Telephone | 602-467-4966
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Fax | 480-419-5401
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JEFF HAAKE
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Credential |
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Telephone | 480-419-5413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0794671-4
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License Number State | AZ
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