Provider Demographics
NPI:1548567522
Name:MEDICAL &SURGICAL EYE SPECIALISTS LTD
Entity Type:Organization
Organization Name:MEDICAL &SURGICAL EYE SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEADOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:602-279-0800
Mailing Address - Street 1:300 E OSBORN RD
Mailing Address - Street 2:203
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2325
Mailing Address - Country:US
Mailing Address - Phone:602-279-0800
Mailing Address - Fax:602-234-8494
Practice Address - Street 1:300 E OSBORN RD
Practice Address - Street 2:203
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2325
Practice Address - Country:US
Practice Address - Phone:602-279-0800
Practice Address - Fax:602-234-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ487488208Medicare UPIN