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NPI Code Detail

MEDICARE: DR. CHRIS SIMOPOULOS O.D.

MEDICARE:  DR. CHRIS  SIMOPOULOS  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
1152W00000XOptometristOPT-001839AZ

General Provider Information

NPI Number : 1093083107
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRIS SIMOPOULOS O.D.
Provider Business Mailing Address
First Line : 1287 N 162ND AVE
Second Line :
City : GOODYEAR
State : AZ
Zip : 85338-4060
Country : US
Telephone Number : 602-790-4610
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 :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2011
Last Update Date : 04/07/2021

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Directions to “ DR. CHRIS SIMOPOULOS O.D.” Practice Location

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