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General NPI Number Information
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NPI Number | 1467637686
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Entity Type | Organization
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Legal Business Name | BURTON EYECARE ASSOCIATES, P.L.L.C.
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 1530 W GLENDALE AVE SUITE 101
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City | PHOENIX
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State | AZ
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Zip | 85021-8578
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Country | US
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Telephone | 602-995-5883
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Fax | 602-995-3365
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Provider Business Mailing Address
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Address Line | 1530 W GLENDALE AVE SUITE 101
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City | PHOENIX
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State | AZ
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Zip | 85021-8578
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Country | US
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Telephone | 602-995-5883
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Fax | 602-995-3365
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHAD DOUGLAS BURTON
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Credential | O.D.
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Telephone | 602-995-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | AZ785
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License Number State | AZ
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