ASSOCIATED RETINA CONSULTANTS LTD. NPI 1164633160

NPI Information

NPI: 1164633160
Provider Name: ASSOCIATED RETINA CONSULTANTS, LTD.
Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

CLIA Number: 03D1065267

Address:
1750 E GLENDALE AVE
PHOENIX, AZ
ZIP 85020
Phone: (602) 242-4928
Get Directions

ASSOCIATED RETINA CONSULTANTS, LTD. is a retina specialist ophthalmology in Phoenix, AZ. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. ASSOCIATED RETINA CONSULTANTS, LTD. NPI is 1164633160. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1750 E GLENDALE AVE
PHOENIX, AZ
ZIP 85020-505
Phone: (602) 242-4928
Fax: (602) 249-4813

The provider's authorized official is Deserie Tsosie .
The authorized official title is Credentialing & Contracting and has the following contact phone number (602) 216-1860.

The CLIA number assigned to this NPI record is 03D1065267 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 11/8/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207WX0107X	Ophthalmology	Retina Specialist			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	299622	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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