Provider Demographics
NPI:1477626976
Name:AFFILIATED OPHTHALMOLOGISTS OF SCOTTSDALE LTD
Entity Type:Organization
Organization Name:AFFILIATED OPHTHALMOLOGISTS OF SCOTTSDALE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-949-1960
Mailing Address - Street 1:7331 E OSBORN DRIVE
Mailing Address - Street 2:SUITE #130
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6415
Mailing Address - Country:US
Mailing Address - Phone:480-949-1960
Mailing Address - Fax:480-949-1871
Practice Address - Street 1:7331 E OSBORN DRIVE
Practice Address - Street 2:SUITE #130
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6415
Practice Address - Country:US
Practice Address - Phone:480-949-1960
Practice Address - Fax:480-949-1871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9787207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D36708Medicare UPIN