Organization
PHOENIX RETINA CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INGEBORG E KIRCH MD (OWNER)
(480) 278-8980
Entity
Organization
Contact information
Practice address
5410 N SCOTTSDALE RD, SUITE A400, PARADISE VALLEY, AZ 85253-5927
(480) 278-8980
Mailing address
5410 N SCOTTSDALE RD, SUITE A400, PARADISE VALLEY, AZ 85253-5927
(480) 278-8980
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
37088
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
HEALTHCARE VALUE MGMT
AZ
01
—
042472266
ONE HEALTH PLAN
—
01
—
0801554
EVERCARE
—
01
—
2094514
FIRST HEALTH
AZ
01
—
2098466
MEDICAID WELFARE
—
05
—
2098466
—
AZ
01
—
69793
CHILDRENS MED SEC PLAN
AZ
01
—
7241458
AETNA US HEALTHCARE
AZ
01
—
784039
MVP HEALTH CARE
—
01
—
90546
FALLON COMM HEALTH PLAN
AZ
01
—
9317749
CIGNA HEALTH PLAN
AZ
01
—
A37828
MEDICARE B
AZ
01
—
AA15528
HARVARD PILGRIM HEALTHCARE
AZ
01
—
J28266
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/13/2009
Last updated
10/21/2010
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