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NPI Code Detail

MEDICARE: NATIONWIDE OPTOMETRY P.C.

MEDICARE: NATIONWIDE OPTOMETRY P.C.
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1982774873
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIONWIDE OPTOMETRY P.C.
Provider Business Mailing Address
First Line : 955 W SOUTHERN AVE STE 101
Second Line :
City : MESA
State : AZ
Zip : 85210-4903
Country : US
Telephone Number : 480-961-1865
Fax Number : 480-893-8172
Provider Business Practice Location Address
First Line : 3788 S 16TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85713-6079
Country : US
Telephone Number : 520-388-9741
Fax Number : 520-388-9750
Authorized Official
Title or Position : PRESIDENT
Name : JARROD CROSS
Credential : OD
Telephone Number : 509-201-0051
Provider Enumeration Date : 11/08/2006
Last Update Date : 11/14/2024

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Directions to “NATIONWIDE OPTOMETRY P.C. ” Practice Location

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