Provider Demographics
NPI:1992868699
Name:JOHN N CHRISAGIS O D P C
Entity type:Organization
Organization Name:JOHN N CHRISAGIS O D P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHRISAGIS
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:480-967-4910
Mailing Address - Street 1:7511 SOUTH MC CLINTOCK DRIVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283
Mailing Address - Country:US
Mailing Address - Phone:480-967-4910
Mailing Address - Fax:480-966-5992
Practice Address - Street 1:7511 SOUTH MC CLINTOCK DRIVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283
Practice Address - Country:US
Practice Address - Phone:480-967-4910
Practice Address - Fax:480-966-5992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWBDNMedicare ID - Type Unspecified