Basic Information
| Provider Information | |||||||||
| NPI: | 1336742790 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BARNET DULANEY PERKINS EYE CENTER II PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 N 22ND ST STE 210 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6025987488 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 COLONIA DE SALUD STE 100A | ||||||||
| Address2: | |||||||||
| City: | SIERRA VISTA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 856352485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204596860 | ||||||||
| FaxNumber: | 6025084830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2020 | ||||||||
| LastUpdateDate: | 11/18/2020 | ||||||||
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| AuthorizedOfficialLastName: | RABINOWITZ | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF MEDICAL OFFICER/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6025084843 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 11/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.