Provider Demographics
NPI:1437615010
Name:CARROT EYE CENTER, PLLC
Entity Type:Organization
Organization Name:CARROT EYE CENTER, PLLC
Other - Org Name:CARROT EYE CENTER, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-703-1564
Mailing Address - Street 1:1500 S DOBSON RD STE 313
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4752
Mailing Address - Country:US
Mailing Address - Phone:480-703-1564
Mailing Address - Fax:480-561-6003
Practice Address - Street 1:1500 S DOBSON RD STE 313
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4752
Practice Address - Country:US
Practice Address - Phone:602-690-0598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ296133Medicaid