Provider Demographics
NPI:1427260918
Name:SANFILIPPO, DONALD (OD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:SANFILIPPO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 S WOODLANDS VILLAGE BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7114
Mailing Address - Country:US
Mailing Address - Phone:928-774-2020
Mailing Address - Fax:
Practice Address - Street 1:2700 S WOODLANDS VILLAGE BLVD
Practice Address - Street 2:SUITE #200
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7114
Practice Address - Country:US
Practice Address - Phone:928-774-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ496152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist