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Organization

DR. JOHN R. MARKHAM PC

Active
Other names
Prescott Vision & Eye Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GREG DAVIS (ADMINISTRATOR)
(928) 778-3950
Entity
Organization

Contact information

Practice address
25 W YAVAPAI ST, WICKENBURG, AZ 85390-3280
(928) 684-2880
(928) 684-3209
Mailing address
1680 WILLOW CREEK RD, PRESCOTT, AZ 86301-1108
(928) 778-3950
(928) 778-3999

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4498
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
033176-001
MERCYCARE
AZ
01
190721
AHCCCS
AZ
05
190721
AZ
01
2Z6546
HEALTH NET
AZ
01
3421045
CIGNA
AZ
01
572818
RAN-AMN
AZ
01
7742967
AETNA
AZ
01
866291-9714
HUMANA
AZ
01
AZ01170
MEDICARE SUBMITTER ID
AZ
01
NNP12599
UNIVERSAL HEALTH CARE
AZ
Enumeration date
04/03/2009
Last updated
04/03/2009
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