Eastern Utah Eye Physicians
Organization Active NPI Ophthalmic Technician/Technologist · Price, UT
NPI 1881801504 · NPPES record last updated Jan 5, 2010
Key facts
- NPI
- 1881801504
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ophthalmic Technician/Technologist 156FX1100X
- License
- 289301-1205 (UT)
- Legal business name
- EASTERN UTAH EYE PHYSICIANS
- Practice address
- 200 N Fairgrounds Rd
Suite 2
Price, UT 84501-4205 - Phone
- (435) 637-8689
- Fax
- (435) 637-1123
- NPI assigned
- May 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Lynelle Hansen
- Title
- Administrator
- Phone
- (435) 637-8689
Practitioners 4
-
Steven Jon Hillam, D.O.
-
Shane Jensen, O.D.
-
Jeffrey E Hansen, MD
-
Timothy L Byers, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050912000346 | UT | Part B Supplier - Clinic/Group Practice | 6204869233 |
Receives reassigned benefits from 4 practitioners Practice locations: Price, UT |
| O20100930090952 | UT | DME Supplier - Physician - Ophthalmology |
6204869233 | Practice locations: Price, UT |
National Provider Directory
Locations
1111 W Victory Way
Ste 110
Craig, CO 81625
Phone (870) 824-3488
200 N Fairgrounds Rd
Ste 2
Price, UT 84501
Phone (435) 637-7860
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Technician/Technologist |
156FX1100X | 289301-1205 | UT | Yes |
| Specialist |
174400000X | 289301-1205 | UT |
Addresses
Primary practice location
200 N Fairgrounds Rd
Suite 2
Price, UT 84501-4205
Mailing address
200 N Fairgrounds Rd
Suite 2
Price, UT 84501-4205
Phone (435) 637-8689
Other providers in Price, UT
- Bryan Scott Drolc
- Stephanie Eleene Dunlap
- Brett Adam Dustin
- Heath Doyle Earl
- Eastern Utah Eye Physicians
- Eastern Utah Imaging
- Eastern Utah Pain
- Eastern Utah Surgical Center
- Eastern Utah Surgical Center
- Eastern Utah Womens Health LLC
All providers in Price, UT · Ophthalmic Technician/Technologist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.