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General NPI Number Information
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NPI Number | 1669671335
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Entity Type | Organization
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Legal Business Name | GOLDMAN EYE LTD
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 7024 S 38TH PL
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City | PHOENIX
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State | AZ
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Zip | 85042-6215
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Country | US
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Telephone | 602-276-2497
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Fax | 602-276-8169
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Provider Business Mailing Address
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Address Line | 7024 S 38TH PL
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City | PHOENIX
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State | AZ
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Zip | 85042-6215
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Country | US
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Telephone | 602-276-2497
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Fax | 602-276-8169
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG C GOLDMAN
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Credential | O.D.
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Telephone | 602-276-2497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1425
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License Number State | AZ
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