Provider Demographics
NPI:1942245410
Name:YUMA EYE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:YUMA EYE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:PODOLSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-726-9564
Mailing Address - Street 1:1881 W 24TH ST
Mailing Address - Street 2:STE. C
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6297
Mailing Address - Country:US
Mailing Address - Phone:928-726-9564
Mailing Address - Fax:
Practice Address - Street 1:1881 W 24TH ST
Practice Address - Street 2:STE. C
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6297
Practice Address - Country:US
Practice Address - Phone:928-726-9564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
67927Medicare ID - Type Unspecified