Organization
OPHTHALMIC SURGEONS & PHYSICIANS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MANSUETO MD (MEMBER MANAGER)
(480) 360-2020
Entity
Organization
Contact information
Practice address
3200 S COUNTRY CLUB WAY, TEMPE, AZ 85282-4054
(480) 360-2020
(480) 839-0208
Mailing address
3200 S COUNTRY CLUB WAY, TEMPE, AZ 85282-4054
(480) 360-2020
(480) 839-0208
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
AZ
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZWCJCC
GROUP MEDICARE
AZ
Enumeration date
02/14/2006
Last updated
09/18/2023
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