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Organization
KOKOPELLI EYE CARE PC
Active
Organization
KOKOPELLI EYE CARE PC
Active
Parent organization
KOKOPELLI EYE CARE, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KOKOPELLI EYE CARE, PC
Authorized official
MR. MICHAEL L HAM MD (PRESIDENT)
(928) 771-9000
Entity
Organization
Contact information
Practice address
412 WHIPPLE ST, PRESCOTT, AZ 86301-1712
(928) 771-9000
(928) 771-9460
Mailing address
2820 N GLASSFORD HILL RD, SUITE 101, PRESCOTT VALLEY, AZ 86314-1242
(928) 775-5606
(928) 772-4999
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC3634
AZ
Other
Enumeration date
04/10/2007
Last updated
11/16/2007
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