Provider Demographics
NPI:1316137250
Name:FINNELL, CAROLYN (OD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:FINNELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N KOLB RD
Mailing Address - Street 2:STE. 212
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4934
Mailing Address - Country:US
Mailing Address - Phone:520-979-1306
Mailing Address - Fax:
Practice Address - Street 1:10501 E SEVEN GENERATIONS WAY STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-5828
Practice Address - Country:US
Practice Address - Phone:520-777-3515
Practice Address - Fax:877-395-0856
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZT3017804152W00000X
AZ1124152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV00277Medicare UPIN
AZZ81760Medicare PIN