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Organization

JAMES A TAMMARO MD PC

Active
Other names
EYES OF ARIZONA VISION AND SURGERY CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES A TAMMARO (OWNER)
(928) 855-9477
Entity
Organization

Contact information

Practice address
40 CAPRI BLVD, SUITE 102, LAKE HAVASU CITY, AZ 86403-5661
(928) 855-9477
(928) 855-1799
Mailing address
PO BOX 3360, LAKE HAVASU CITY, AZ 86405-3360
(928) 855-9477
(928) 855-1799

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
05-08778
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03C0001024
MEDICARE NSC
AZ
05
077182
AZ
01
AZ0200500
BCBS
AZ
Enumeration date
02/07/2006
Last updated
12/15/2010
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