Provider Demographics
NPI:1093083107
Name:SIMOPOULOS, CHRIS (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:SIMOPOULOS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 N 162ND AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-4060
Mailing Address - Country:US
Mailing Address - Phone:602-790-4610
Mailing Address - Fax:
Practice Address - Street 1:7575 W LOWER BUCKEYE RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-3450
Practice Address - Country:US
Practice Address - Phone:623-907-5952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-001839152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist