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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