Provider Demographics
NPI:1174644371
Name:SUMMIT VISION CENTER PLLC
Entity Type:Organization
Organization Name:SUMMIT VISION CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER AND SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LANGFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:435-563-2020
Mailing Address - Street 1:136 E 800 S
Mailing Address - Street 2:SUITE C
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-9673
Mailing Address - Country:US
Mailing Address - Phone:435-563-2020
Mailing Address - Fax:435-563-6562
Practice Address - Street 1:136 E 800 S
Practice Address - Street 2:SUITE C
Practice Address - City:SMITHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84335-9673
Practice Address - Country:US
Practice Address - Phone:435-563-2020
Practice Address - Fax:435-563-6562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5354587-8904152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty