=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700031556
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALAN P. SCHWARTZ M.D.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2008
-----------------------------------------------------
Last Update Date | 01/15/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 539 E GLENDALE AVE
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85020-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-274-1880
-----------------------------------------------------
Fax | 602-274-1910
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 539 E GLENDALE AVE
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85020-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-274-1880
-----------------------------------------------------
Fax | 602-274-1910
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSICIAN
-----------------------------------------------------
Name | ALAN P SCHWARTZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 602-274-1880
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 6381
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------