Provider Demographics
NPI:1629862529
Name:RISSER EYE CLINIC, LLC
Entity type:Organization
Organization Name:RISSER EYE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:RISSER
Authorized Official - Suffix:V
Authorized Official - Credentials:MD
Authorized Official - Phone:602-402-8624
Mailing Address - Street 1:302 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5386
Mailing Address - Country:US
Mailing Address - Phone:928-474-4126
Mailing Address - Fax:928-474-4534
Practice Address - Street 1:302 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5386
Practice Address - Country:US
Practice Address - Phone:928-474-4126
Practice Address - Fax:928-474-4534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty