Desert Ophthalmology, P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

5469 Issued in AZ

Legal business name

DESERT OPHTHALMOLOGY, P.C.

Practice address

5860 S Hospital Dr Ste 101
Globe, AZ 85501-9449

Phone

(928) 425-5203

Fax

(928) 425-5620

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary Alan Gustason, M.D.

Title

President

Phone

(928) 425-5203

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144328485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 N 19TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202319",
            "telephone_number": "928-425-5203",
            "fax_number": "928-425-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 S HOSPITAL DR STE 101",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855019449",
            "telephone_number": "928-425-5203",
            "fax_number": "928-425-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT OPHTHALMOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUSTASON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-425-5203",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "5469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Lynn Daggett, MD
• Russell Scott Dal Molin, D.C.
• Jennifer Lyn Davis, LPN
• Natalija De Retana, AGNP
• Desert Oasis Wellness Center, PLLC
• Desert Pain and Rehab Specialists
• Destiny School Inc.
• Diamond Dental Globe LLC
• Diamond M Dental Associates, LLC
• Helen Dike

• Ophthalmology Physician in Globe, AZ
• Providers in Globe, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.