MEDICARE: TAMI C. FRISKE, O.D., PC

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	152W00000X	Optometrist	520	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S5055	OTHER	AZ	DME
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275743718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMI C. FRISKE, O.D., PC

Provider Business Mailing Address
First Line	:	5720 E BROADWAY BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-3814
Country	:	US
Telephone Number	:	520-747-8583
Fax Number	:	520-747-8561

Provider Business Practice Location Address
First Line	:	5720 E BROADWAY BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-3814
Country	:	US
Telephone Number	:	520-747-8583
Fax Number	:	520-747-8561

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TAMI C FRISKE
Credential	:	O.D.
Telephone Number	:	520-747-8583

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	05/05/2011

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