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General NPI Number Information
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NPI Number | 1831206408
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Entity Type | Individual
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Provider Name | MARY KATHLEEN CARRIKER M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3125 N 32ND ST 100
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City | PHOENIX
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State | AZ
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Zip | 85018-6281
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Country | US
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Telephone | 602-956-7414
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Fax | 602-957-3227
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Provider Business Mailing Address
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Address Line | 3125 N. 32ND STREET 100
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City | PHOENIX
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State | AZ
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Zip | 85018-6281
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Country | US
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Telephone | 602-956-7414
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Fax | 602-957-3227
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5301
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License Number State | AZ
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