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General NPI Number Information
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NPI Number | 1437532793
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Entity Type | Individual
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Provider Name | SARAH BURCH MARIETTA O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 2222 E CAMELBACK RD STE 250M
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City | PHOENIX
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State | AZ
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Zip | 85016-3427
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Country | US
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Telephone | 602-840-3501
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Fax | 602-840-3671
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Provider Business Mailing Address
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Address Line | 220 N MCKEMY AVE
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City | CHANDLER
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State | AZ
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Zip | 85226-2651
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Country | US
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Telephone | 480-961-1865
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Fax | 480-893-8172
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3244
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-002527
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License Number State | AZ
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