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Contact Information

RETINA AND VITREOUS SURGEONS OF UTAH INC
1055 N 300 W
SUITE 210
PROVO, UT84604-3344
 Phone: 801-357-7704
 Fax: 801-357-7424
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for RETINA AND VITREOUS SURGEONS OF UTAH INC · (Female)

NPI Number 1528186954
Status Active
Credentials
Entity Individual
Enumeration date 03/26/2007
Last updated 04/28/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • UT License # 165213-1205
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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