MEDICARE: DR. KEITH ERIC VOTENS 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
1	152W00000X	Optometrist	01156	AZ
2	152WC0802X	Corneal and Contact Management Optometrist	01156	AZ
3	152WL0500X	Low Vision Rehabilitation Optometrist	01156	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z144649	OTHER	AZ	BCBS
2	AZ0902810	OTHER	AZ	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518964709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH ERIC VOTENS O.D

Provider Business Mailing Address
First Line	:	7552 N LA CHOLLA BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2307
Country	:	US
Telephone Number	:	520-744-1711
Fax Number	:

Provider Business Practice Location Address
First Line	:	7552 N LA CHOLLA BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2307
Country	:	US
Telephone Number	:	520-744-1711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	02/03/2014

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Directions to “ DR. KEITH ERIC VOTENS O.D” Practice Location

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