Provider Demographics
NPI:1942078969
Name:EYE CONSULTANTS AND SURGEONS OF ARIZONA LLC
Entity Type:Organization
Organization Name:EYE CONSULTANTS AND SURGEONS OF ARIZONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:KONTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-717-8580
Mailing Address - Street 1:1215 W RIO SALADO PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2954
Mailing Address - Country:US
Mailing Address - Phone:480-717-8580
Mailing Address - Fax:
Practice Address - Street 1:1215 W RIO SALADO PKWY STE 101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2954
Practice Address - Country:US
Practice Address - Phone:480-717-8580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty