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General NPI Number Information
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NPI Number | 1770735847
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Entity Type | Organization
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Legal Business Name | PATRICK PADRNOS O.D. P.C.
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 1135 S PLAZA WAY
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-6317
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Country | US
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Telephone | 928-779-5600
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Fax | 928-779-5701
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Provider Business Mailing Address
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Address Line | 1135 S PLAZA WAY
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-6317
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Country | US
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Telephone | 928-779-5600
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Fax | 928-779-5701
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICK PADRNOS
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Credential | O.D.
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Telephone | 928-779-5600
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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 | 646
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License Number State | AZ
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