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NPI Code Detail

MEDICARE: DR. MICHAEL SCOTT KAMINSKI O.D.

MEDICARE: DR. MICHAEL SCOTT KAMINSKI O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1316AZ

General Provider Information

NPI Number : 1033207717
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL SCOTT KAMINSKI O.D.
Provider Business Mailing Address
First Line : 20578 W HOLT DR
Second Line :
City : BUCKEYE
State : AZ
Zip : 85396-7609
Country : US
Telephone Number : 623-466-7501
Fax Number :
Provider Business Practice Location Address
First Line : 7575 W LOWER BUCKEYE RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85043-3450
Country : US
Telephone Number : 623-907-5952
Fax Number : 623-907-9968
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/08/2007

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