EYE SURG OF UTAH LLC NPI 1629069281

NPI Information

NPI: 1629069281
Provider Name: EYE SURG OF UTAH, LLC
Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

CLIA Number: 46D0970877

Address:
11820 SOUTH STATE STREET
150
DRAPER, UT
ZIP 84020
Phone: (801) 568-0200
Get Directions

EYE SURG OF UTAH, LLC is an ophthalmologic surgery clinic center in Draper, UT. EYE SURG OF UTAH, LLC NPI is 1629069281. The provider is registered as an organization entity type.

The provider's business location address is:

11820 SOUTH STATE STREET
150
DRAPER, UT
ZIP 84020-160
Phone: (801) 568-0200
Fax: (801) 563-0200

The provider's authorized official is Phillip C Hoopes .
The authorized official title is Ceo/owner and has the following contact phone number (801) 568-0200.

The CLIA number assigned to this NPI record is 46D0970877 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2005 and was last updated on 10/9/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QS0132X	Clinic/Center	Ophthalmologic Surgery	2000ASF11451	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	=========001	MEDICAID	UTAH
2	0TH000	MEDICARE UPIN	UTAH
3	000001057	MEDICARE PIN	UTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »