Organization
DESERT OPHTHALMOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ALAN GUSTASON M.D. (PRESIDENT)
(928) 425-5203
Entity
Organization
Contact information
Practice address
5860 S HOSPITAL DR STE 101, GLOBE, AZ 85501-9449
(928) 425-5203
(928) 425-5620
Mailing address
9615 N 19TH ST, PHOENIX, AZ 85020-2319
(928) 425-5203
(928) 425-5620
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
5469
AZ
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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