Provider Demographics
NPI:1437242229
Name:FRANZ, JEFFREY LEE (OD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEE
Last Name:FRANZ
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 1:960 E FRY BLVD
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2640
Mailing Address - Country:US
Mailing Address - Phone:520-515-3937
Mailing Address - Fax:520-515-3860
Practice Address - Street 1:960 E FRY BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2640
Practice Address - Country:US
Practice Address - Phone:520-515-3937
Practice Address - Fax:520-515-3860
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ291152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ65294Medicare ID - Type Unspecified
AZT47200Medicare UPIN
AZ4465630001Medicare NSC