Provider Demographics
NPI:1245444884
Name:RETINA CENTERS P.C.
Entity type:Organization
Organization Name:RETINA CENTERS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVALIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-742-7422
Mailing Address - Street 1:6585 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5611
Mailing Address - Country:US
Mailing Address - Phone:520-742-7422
Mailing Address - Fax:520-229-9169
Practice Address - Street 1:6585 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5611
Practice Address - Country:US
Practice Address - Phone:520-742-7422
Practice Address - Fax:520-229-9169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty