Provider Demographics
NPI:1457334641
Name:AFFILIATED EYE SURGEONS LTD
Entity Type:Organization
Organization Name:AFFILIATED EYE SURGEONS LTD
Other - Org Name:AFFILIATED EYE SURGEONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-776-6722
Mailing Address - Street 1:3330 N 2ND ST STE 600
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2395
Mailing Address - Country:US
Mailing Address - Phone:602-263-9345
Mailing Address - Fax:602-263-0778
Practice Address - Street 1:3330 N 2ND ST STE 600
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2395
Practice Address - Country:US
Practice Address - Phone:602-263-9345
Practice Address - Fax:602-263-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCS2496OtherRAILROAD MEDICARE
AZCS2496OtherRAILROAD MEDICARE