Provider Demographics
NPI:1255679262
Name:FARSHID PAYDAR, M.D.,P.C.
Entity Type:Organization
Organization Name:FARSHID PAYDAR, M.D.,P.C.
Other - Org Name:THE EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-203-9600
Mailing Address - Street 1:2530 W STATE ROUTE 89A STE B3
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5259
Mailing Address - Country:US
Mailing Address - Phone:928-203-9600
Mailing Address - Fax:928-203-9601
Practice Address - Street 1:401 S CALVARY WAY STE D
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4165
Practice Address - Country:US
Practice Address - Phone:928-203-9600
Practice Address - Fax:928-203-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26754332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies