Organization
MILES EYE CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA S BURGESS (CREDENTIALING MANAGER)
(928) 535-6667
Entity
Organization
Contact information
Practice address
5860 S HOSPITAL DR, SUITE 101, GLOBE, AZ 85501-9449
(928) 425-5203
(928) 425-5620
Mailing address
PO BOX 969, OVERGAARD, AZ 85933-0969
(928) 535-6667
(928) 535-5561
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
586099
—
AZ
Enumeration date
07/24/2014
Last updated
07/24/2014
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