Organization
JOHN R. MARKHAM PC
Active
Other names
Prescott Vision & Eye Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT MARKHAM DO (MEDICAL DIRECTOR)
(928) 778-3950
Entity
Organization
Contact information
Practice address
1680 WILLOW CREEK RD, PRESCOTT, AZ 86301-1108
(928) 778-3950
(928) 778-3999
Mailing address
1680 WILLOW CREEK RD, PRESCOTT, AZ 86301-1108
(928) 778-3950
(928) 778-3999
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033176
—
AZ
01
—
15220
AVESIS
—
05
—
190721
—
AZ
01
—
5858351
AETNA
—
01
—
63119
MEDICARE - UNSPECIFIED
—
01
—
866291-9714
HUMANA
—
01
—
AZ01170
MEDICARE SUBMITTER ID - CLINIC
—
Enumeration date
04/15/2008
Last updated
10/15/2008
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