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General NPI Number Information
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NPI Number | 1659513760
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Entity Type | Organization
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Legal Business Name | DR. JOHN R. MARKHAM PC
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 25 W YAVAPAI ST
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City | WICKENBURG
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State | AZ
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Zip | 85390-3280
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Country | US
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Telephone | 928-684-2880
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Fax | 928-684-3209
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Provider Business Mailing Address
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Address Line | 1680 WILLOW CREEK RD
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City | PRESCOTT
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State | AZ
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Zip | 86301-1108
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Country | US
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Telephone | 928-778-3950
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Fax | 928-778-3999
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GREG DAVIS
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Credential |
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Telephone | 928-778-3950
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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 | 4498
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License Number State | AZ
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