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General NPI Number Information
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NPI Number | 1659025450
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Entity Type | Organization
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Legal Business Name | DESERT EYECARE PLLC
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 13731 W BELL RD
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City | SURPRISE
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State | AZ
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Zip | 85374-3871
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Country | US
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Telephone | 623-975-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 9938 W VILLA HERMOSA
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City | PEORIA
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State | AZ
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Zip | 85383-1472
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Country | US
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Telephone | 623-293-1200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RACHAEL MARTHA SMITH
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Credential | O.D.
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Telephone | 623-293-1752
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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 |
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License Number State |
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