Provider Demographics
NPI:1659537330
Name:ORDYNSKY, CAROL LYN G (OD)
Entity Type:Individual
Prefix:
First Name:CAROL LYN
Middle Name:G
Last Name:ORDYNSKY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11103 WEST AVE
Mailing Address - Street 2:STE 6
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1370
Mailing Address - Country:US
Mailing Address - Phone:210-524-6803
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:7000 E MAYO BLVD
Practice Address - Street 2:SPACE A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-6151
Practice Address - Country:US
Practice Address - Phone:480-513-3106
Practice Address - Fax:480-515-6247
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ743T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist