Wendover Eye Care, Inc
Organization Active NPI Optometrist · Wendover, UT
NPI 1447340799 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1447340799
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 62579469934 (UT)
- Legal business name
- WENDOVER EYE CARE, INC
- Practice address
- 479 E Wendover Blvd
Wendover, UT 84083 - Phone
- (435) 665-7923
- Fax
- (435) 665-7923
- NPI assigned
- Oct 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Scott M Allen, OD
- Title
- Officer
- Phone
- (435) 665-7923
Practitioners 1
-
Lanny F Duclos, OD
National Provider Directory
Locations
307 N 300 W
Ste 302
Kaysville, UT 84037
Phone (801) 444-9977
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 62579469934 | UT | Yes |
| Optometrist |
152W00000X | 1138799934 | UT |
Addresses
Primary practice location
479 E Wendover Blvd
Wendover, UT 84083
Mailing address
307 N 300 W
Suite 302
Kaysville, UT 84037-1852
Phone (435) 665-7923
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62579469902001 | Other | BLUE CROSS BLUE SHIELD |
Other providers in Wendover, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.