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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
Update your record

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