Organization
AFFILIATED OPHTHALMIC SVC
Active
Organization
AFFILIATED OPHTHALMIC SVC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. E FREDRICK BLOEMKER MD (PRESIDENT)
(602) 955-5104
Entity
Organization
Contact information
Practice address
500 W THOMAS RD, SUITE #250, PHOENIX, AZ 85013-4224
(602) 263-9345
Mailing address
3500 E LINCOLN DR # 30, PHOENIX, AZ 85018-1010
(602) 955-5104
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS2496
RAILROAD MEDICARE
—
Enumeration date
02/20/2007
Last updated
11/19/2007
Update your record
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