Retina and Vitreous Surgeons of Utah Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

165213-1205 Issued in UT

Legal business name

RETINA AND VITREOUS SURGEONS OF UTAH INC

Practice address

1055 N 300 W
Suite 210
Provo, UT 84604-3344

Phone

(801) 357-7704

Fax

(801) 357-7424

NPI assigned

Mar 26, 2007

Last updated

Apr 28, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Alan Carver, MD

Title

President Or Ceo

Phone

(801) 357-7704

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1528186954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "SUITE 210",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043344",
            "telephone_number": "801-357-7704",
            "fax_number": "801-357-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "SUITE 210",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043344",
            "telephone_number": "801-357-7704",
            "fax_number": "801-357-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA AND VITREOUS SURGEONS OF UTAH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "CARVER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT OR CEO",
        "authorized_official_telephone_number": "801-357-7704",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "165213-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Provo, UT
• Providers in Provo, UT by specialty
• Ophthalmology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.