Organization
OCULOPLASTIC EYE SURGEONS OF PHOENIX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA D MIHORA M.D. (OWNER)
(480) 788-1134
Entity
Organization
Contact information
Practice address
3811 E BELL RD, SUITE 106, PHOENIX, AZ 85032-2138
(480) 788-1134
Mailing address
22320 N 59TH LN, GLENDALE, AZ 85310-4264
(480) 788-1134
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
44635
AZ
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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