Provider Demographics
NPI:1902945132
Name:CHRIS JARON OD PC
Entity Type:Organization
Organization Name:CHRIS JARON OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:JARON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:623-512-4052
Mailing Address - Street 1:12725 W INDIAN SCHOOL RD STE C104
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-9523
Mailing Address - Country:US
Mailing Address - Phone:623-512-4052
Mailing Address - Fax:623-512-4053
Practice Address - Street 1:12725 W INDIAN SCHOOL RD STE C104
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-9523
Practice Address - Country:US
Practice Address - Phone:623-512-4052
Practice Address - Fax:623-512-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1417152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101571Medicare PIN