MEDICARE: ASSOCIATED OPHTHALMOLOGIST

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
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1245561000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED OPHTHALMOLOGIST

Provider Business Mailing Address
First Line	:	7245 E OSBORN RD
Second Line	:	#4
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251
Country	:	US
Telephone Number	:	480-994-5012
Fax Number	:	480-990-7364

Provider Business Practice Location Address
First Line	:	5620 W THUNDERBIRD RD STE B1
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4638
Country	:	US
Telephone Number	:	602-547-2002
Fax Number	:	480-990-7364

Authorized Official
Title or Position	:	CFO
Name	:	BRANDI RESHETAR
Credential	:
Telephone Number	:	480-990-7271

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	04/27/2023

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Directions to “ASSOCIATED OPHTHALMOLOGIST ” Practice Location

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