Individual
TIMOTHY JOHN MCAULIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4015 EAST BELL ROAD, SUITE # 136, PHOENIX, AZ 85032-2243
(602) 971-5858
(602) 404-1879
Mailing address
4015 EAST BELL ROAD, SUITE # 136, PHOENIX, AZ 85032-2243
(602) 971-5858
(602) 404-1879
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
636
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86-0649146
VISION SERVICE PLAN TAXID
AZ
01
—
AZ0636
EYEMED PROVIDER #
AZ
Enumeration date
05/08/2007
Last updated
03/07/2023
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