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NPI Code Detail

MEDICARE: MILLENNIUM VISION INC

MEDICARE: MILLENNIUM VISION INC
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
1207W00000XOphthalmology PhysicianAZ
2207W00000XOphthalmology Physician0794671-4AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184730251
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILLENNIUM VISION INC
Provider Business Mailing Address
First Line : 18325 N ALLIED WAY STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-3106
Country : US
Telephone Number : 602-467-4966
Fax Number : 480-419-5401
Provider Business Practice Location Address
First Line : 18325 N ALLIED WAY
Second Line : SUITE 100
City : PHOENIX
State : AZ
Zip : 85054-3106
Country : US
Telephone Number : 602-467-4966
Fax Number : 480-419-5401
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : JEFF HAAKE
Credential :
Telephone Number : 480-419-5413
Provider Enumeration Date : 08/22/2006
Last Update Date : 10/31/2025

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Directions to “MILLENNIUM VISION INC ” Practice Location

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