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General NPI Number Information
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NPI Number | 1346423266
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Entity Type | Organization
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Legal Business Name | OPTICS OF SCOTTSDALE LLC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 20301 N HAYDEN RD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3881
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Country | US
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Telephone | 480-991-0509
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Fax |
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Provider Business Mailing Address
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Address Line | 20301 N HAYDEN RD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3881
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Country | US
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Telephone | 480-991-0509
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JILL INGRAM RAGO
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Credential | OD
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Telephone | 480-563-0908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 973
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License Number State | AZ
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