Organization
ARIZONA OPHTHALMOLOGY SPECIALISTS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE SA B JACKSON MD (PHYSICIAN)
(480) 615-2020
Entity
Organization
Contact information
Practice address
4824 E BASELINE RD, SUITE 110, MESA, AZ 85206-4676
(480) 615-2020
(480) 219-9957
Mailing address
4824 E BASELINE RD, SUITE 110, MESA, AZ 85206-4676
(480) 615-2020
(480) 219-9957
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62874
PTAN
AZ
Enumeration date
07/20/2006
Last updated
12/28/2016
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