Provider Demographics
NPI:1114324670
Name:SOCKEYE VISION MURRAY, PLLC
Entity Type:Organization
Organization Name:SOCKEYE VISION MURRAY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:907-841-5851
Mailing Address - Street 1:228 E 6400 S
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7305
Mailing Address - Country:US
Mailing Address - Phone:801-263-9125
Mailing Address - Fax:801-269-1339
Practice Address - Street 1:228 E 6400 S
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7305
Practice Address - Country:US
Practice Address - Phone:801-263-9125
Practice Address - Fax:801-269-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-29
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT90763589934152W00000X, 152WC0802X, 152WP0200X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty