Provider Demographics
NPI:1164834834
Name:DUVAL, DEVIN ACEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:ACEL
Last Name:DUVAL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 W 100 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-5493
Mailing Address - Country:US
Mailing Address - Phone:801-800-8508
Mailing Address - Fax:801-800-8508
Practice Address - Street 1:320 RIVER PARK DR STE 245
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-6065
Practice Address - Country:US
Practice Address - Phone:801-800-8508
Practice Address - Fax:385-595-0195
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9042285-9934152WP0200X, 152WS0006X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1164834834Medicaid