Organization
MOHAVE EYE CENTER, LTD
Active
Parent organization
MOHAVE EYE CENTER, LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOHAVE EYE CENTER, LTD
Authorized official
KATHRINE WINTERS (ADMINISTRATOR)
(928) 753-2106
Entity
Organization
Contact information
Practice address
3003 HIGHWAY 95, SUITE 11, BULLHEAD CITY, AZ 86442-7860
(928) 763-1000
(928) 758-4983
Mailing address
1925 FLORENCE AVE, KINGMAN, AZ 86401-4617
(928) 753-2106
(928) 753-4283
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100290003
PTAN
AZ
01
—
Z20872
MEDICARE
AZ
Enumeration date
08/03/2016
Last updated
08/03/2016
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