MEDICARE: SOUTHWESTERN EYE CENTER LTD

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1326089715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWESTERN EYE CENTER LTD

Provider Business Mailing Address
First Line	:	63 S ROCKFORD DR STE 220
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85288-6226
Country	:	US
Telephone Number	:	602-598-7488
Fax Number	:	602-231-6215

Provider Business Practice Location Address
First Line	:	1600 WILLOW CREEK RD
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86301-1108
Country	:	US
Telephone Number	:	928-776-7477
Fax Number	:	928-776-0693

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	ARTHUR D BROOKFIELD
Credential	:
Telephone Number	:	602-598-7488

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	01/16/2024

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