Basic Information
| Provider Information | |||||||||
| NPI: | 1740671684 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARNET DULANEY PERKINS EYE CENTER, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 N 22ND ST | ||||||||
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| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850164701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029551000 | ||||||||
| FaxNumber: | 6025084830 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 E. WHITE MOUNTAIN BLVD | ||||||||
| Address2: | SUITE B4 | ||||||||
| City: | PINETOP | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029551000 | ||||||||
| FaxNumber: | 6025084830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2015 | ||||||||
| LastUpdateDate: | 09/13/2017 | ||||||||
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| AuthorizedOfficialLastName: | SALAZAR | ||||||||
| AuthorizedOfficialFirstName: | CECILIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, CREDENTIALING & CONTRACTS | ||||||||
| AuthorizedOfficialTelephone: | 6029551000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.