Organization
KOKOPELLI EYE CARE PC
Active
Other names
Kokopelli Eye Institute
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LEE HAM MD (PRESIDENT)
(928) 775-5606
Entity
Organization
Contact information
Practice address
5140 W PEORIA AVE STE 116, GLENDALE, AZ 85302-1631
(844) 565-6393
(844) 329-5656
Mailing address
2820 N GLASSFORD HILL RD, PRESCOTT VALLEY, AZ 86314-1242
(928) 771-9000
(928) 759-9902
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
26357
AZ
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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