KOKOPELLI EYE CARE SURGERY CENTER NPI 1205858875

NPI Information

NPI: 1205858875
Provider Name: KOKOPELLI EYE CARE SURGERY CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
2820 N GLASSFORD HILL RD
PRESCOTT VALLEY, AZ
ZIP 86314
Phone: (928) 775-5606
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KOKOPELLI EYE CARE SURGERY CENTER is an ambulatory surgical clinic center in Prescott Valley, AZ. KOKOPELLI EYE CARE SURGERY CENTER NPI is 1205858875. The provider is registered as an organization entity type.

The provider's business location address is:

2820 N GLASSFORD HILL RD
PRESCOTT VALLEY, AZ
ZIP 86314-242
Phone: (928) 775-5606
Fax: (928) 772-4999

The provider's authorized official is Michael Lee Ham .
The authorized official title is Owner/president and has the following contact phone number (928) 775-5606.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 7/10/2007.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	OSC 0078	ARIZONA	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	Z24396	MEDICARE ID-TYPE UNSPECIFIED	ARIZONA	MEDICARE IDENTIFIER

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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