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Contact Information

PHOENIX OCULOPLASTIC CONSULTANTS, PLLC
3410 N 4TH AVE
PHOENIX, AZ85013-3905
 Phone: 602-257-1499
 Fax: 480-361-3517
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery Within the Head and Neck

2082S0099X 02 Physician/General Surgery
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for PHOENIX OCULOPLASTIC CONSULTANTS, PLLC

NPI Number 1497009641
LBN Legal business name PHOENIX OCULOPLASTIC CONSULTANTS, PLLC
Authorized official MISHA FAUSTINA - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/08/2012
Last updated 11/08/2012 - About 14 years ago
Identifiers
AZ License # 33016
AZ Medicaid 608730
AZ Medicaid 868672
Other 1669438057 NPI
Other 1952570194 NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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