Provider Demographics
NPI:1912193608
Name:WILLIAM A CRUM, O.D., P.L.C.
Entity Type:Organization
Organization Name:WILLIAM A CRUM, O.D., P.L.C.
Other - Org Name:INVISION EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRUM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-940-3222
Mailing Address - Street 1:5965 W RAY RD STE 26
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1892
Mailing Address - Country:US
Mailing Address - Phone:480-940-3222
Mailing Address - Fax:480-940-9946
Practice Address - Street 1:5965 W RAY RD STE 26
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-1892
Practice Address - Country:US
Practice Address - Phone:480-940-3222
Practice Address - Fax:480-940-9946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ1374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty